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Anatomic site for proximal tibial nerve compression: a cadaver study.

Eric H Williams¹, Christopher G Williams, Gedge D Rosson

¹Division of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore MD, USA. williamseb@gmail.com

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Summary

Tibial nerve compression under the soleus muscle

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Area of Science:

Anatomy
Neuroscience

Background:

Tibial nerve compression is a common cause of foot pain.
The soleus muscle's fibromuscular sling is a rarely discussed potential compression site.

Purpose of the Study:

To investigate the anatomical relationship between the soleus muscle's fibromuscular sling and the tibial nerve.
To identify the prevalence of tibial nerve compression at this site.

Main Methods:

Dissection of 36 cadaver limbs.
Recording of leg length, soleal fibromuscular sling location, fibrous band presence, and tibial nerve narrowing.

Main Results:

The fibromuscular soleal sling was located 9.3 cm distal to the medial tibial plateau.
A fibrous band was present in 56% of specimens.
Focal tibial nerve narrowing under the sling was observed in only 8% of specimens.

Conclusions:

The fibromuscular sling of the soleus muscle can be a potential compression site for the tibial nerve.
Findings may explain persistent plantar numbness after tarsal tunnel decompression and aid in diagnosing toe flexion weakness.