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Topography of human ankle joint: focused on posterior tibial artery and tibial nerve.

Kim DI, Kim YS, Han SH - Anat Cell Biol (2015)

Bottom Line: Thirteen measurements and classification showed statistically significant differences between both sexes (P<0.05).It is determined the average position of neurovascular structures in the human ankle region and recorded the differences between the sexes and amongst the populations.These results would be helpful for the diagnosis and treatment of foot pain.

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing, College of Nursing, Keimyung University, Daegu, Korea.

ABSTRACT
Most of foot pain occurs by the entrapment of the tibial nerve and its branches. Some studies have reported the location of the tibial nerve; however, textbooks and researches have not described the posterior tibial artery and the relationship between the tibal nerve and the posterior tibial artery in detail. The purpose of this study was to analyze the location of neurovascular structures and bifurcations of the nerve and artery in the ankle region based on the anatomical landmarks. Ninety feet of embalmed human cadavers were examined. All measurements were evaluated based on a reference line. Neurovascular structures were classified based on the relationship between the tibial nerve and the posterior tibial artery. The bifurcation of arteries and nerves were expressed by X- and Y-coordinates. Based on the reference line, 9 measurements were examined. The most common type I (55.6%), was the posterior tibial artery located medial to the tibial nerve. Neurovascular structures were located less than 50% of the distance between M and C from M at the reference line. The bifurcation of the posterior tibial artery was 41% in X-coordinate, -38% in Y-coordinate, and that of the tibial nerve was 48%, and -10%, respectively. Thirteen measurements and classification showed statistically significant differences between both sexes (P<0.05). It is determined the average position of neurovascular structures in the human ankle region and recorded the differences between the sexes and amongst the populations. These results would be helpful for the diagnosis and treatment of foot pain.

No MeSH data available.


Related in: MedlinePlus

Schematic diagram showing the bony landmarks and a reference line. M, inferior tip of medial malleolus of the tibia; C, posterior superior tip of calcaneal tuberosity; DLBA, Perpendicular distance from Line A to bifurcation of posterior tibial artery; DLBN, Perpendicular distance from Line A to bifurcation of tibial nerve; DMA, distance between inferior tip of medial malleolus of tibia and posterior tibial artery; DMBA, distance from inferior tip of medial malleolus of tibia to location of bifurcation of posterior tibial artery; DMBN, distance from inferior tip of medial malleolus of tibia to location of bifurcation of tibial nerve; DMC, distance between inferior tip of medial malleolus of tibia and superior tip of calcaneus; DMN, distance between inferior tip of medial malleolus of tibia and tibial nerve; P, medial process of calcaneal tuberosity; Line A, reference line from M to C.
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Figure 1: Schematic diagram showing the bony landmarks and a reference line. M, inferior tip of medial malleolus of the tibia; C, posterior superior tip of calcaneal tuberosity; DLBA, Perpendicular distance from Line A to bifurcation of posterior tibial artery; DLBN, Perpendicular distance from Line A to bifurcation of tibial nerve; DMA, distance between inferior tip of medial malleolus of tibia and posterior tibial artery; DMBA, distance from inferior tip of medial malleolus of tibia to location of bifurcation of posterior tibial artery; DMBN, distance from inferior tip of medial malleolus of tibia to location of bifurcation of tibial nerve; DMC, distance between inferior tip of medial malleolus of tibia and superior tip of calcaneus; DMN, distance between inferior tip of medial malleolus of tibia and tibial nerve; P, medial process of calcaneal tuberosity; Line A, reference line from M to C.

Mentions: Ninety feet, 41 male feet and 49 female feet, of embalmed human cadavers were examined. There were a total of 43 right feet and 47 left feet. The average age of cadavers was 70 years (range, 46-96 years). After the removal of skin and fat from the foot and ankle, 3 bony landmarks were marked at the inferior tip of the medial malleolus of the tibia (M), the posterior superior tip of the calcaneal tuberosity (C), and the medial process of the calcaneal tuberosity (P) (Fig. 1). Based on the strategy of classification and measurements, a line between the medial malleolus of the tibia (M) and the posterior superior tip of the calcaneal tuberosity (C) was set as a reference line (Line A).


Topography of human ankle joint: focused on posterior tibial artery and tibial nerve.

Kim DI, Kim YS, Han SH - Anat Cell Biol (2015)

Schematic diagram showing the bony landmarks and a reference line. M, inferior tip of medial malleolus of the tibia; C, posterior superior tip of calcaneal tuberosity; DLBA, Perpendicular distance from Line A to bifurcation of posterior tibial artery; DLBN, Perpendicular distance from Line A to bifurcation of tibial nerve; DMA, distance between inferior tip of medial malleolus of tibia and posterior tibial artery; DMBA, distance from inferior tip of medial malleolus of tibia to location of bifurcation of posterior tibial artery; DMBN, distance from inferior tip of medial malleolus of tibia to location of bifurcation of tibial nerve; DMC, distance between inferior tip of medial malleolus of tibia and superior tip of calcaneus; DMN, distance between inferior tip of medial malleolus of tibia and tibial nerve; P, medial process of calcaneal tuberosity; Line A, reference line from M to C.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4488641&req=5

Figure 1: Schematic diagram showing the bony landmarks and a reference line. M, inferior tip of medial malleolus of the tibia; C, posterior superior tip of calcaneal tuberosity; DLBA, Perpendicular distance from Line A to bifurcation of posterior tibial artery; DLBN, Perpendicular distance from Line A to bifurcation of tibial nerve; DMA, distance between inferior tip of medial malleolus of tibia and posterior tibial artery; DMBA, distance from inferior tip of medial malleolus of tibia to location of bifurcation of posterior tibial artery; DMBN, distance from inferior tip of medial malleolus of tibia to location of bifurcation of tibial nerve; DMC, distance between inferior tip of medial malleolus of tibia and superior tip of calcaneus; DMN, distance between inferior tip of medial malleolus of tibia and tibial nerve; P, medial process of calcaneal tuberosity; Line A, reference line from M to C.
Mentions: Ninety feet, 41 male feet and 49 female feet, of embalmed human cadavers were examined. There were a total of 43 right feet and 47 left feet. The average age of cadavers was 70 years (range, 46-96 years). After the removal of skin and fat from the foot and ankle, 3 bony landmarks were marked at the inferior tip of the medial malleolus of the tibia (M), the posterior superior tip of the calcaneal tuberosity (C), and the medial process of the calcaneal tuberosity (P) (Fig. 1). Based on the strategy of classification and measurements, a line between the medial malleolus of the tibia (M) and the posterior superior tip of the calcaneal tuberosity (C) was set as a reference line (Line A).

Bottom Line: Thirteen measurements and classification showed statistically significant differences between both sexes (P<0.05).It is determined the average position of neurovascular structures in the human ankle region and recorded the differences between the sexes and amongst the populations.These results would be helpful for the diagnosis and treatment of foot pain.

View Article: PubMed Central - PubMed

Affiliation: Department of Nursing, College of Nursing, Keimyung University, Daegu, Korea.

ABSTRACT
Most of foot pain occurs by the entrapment of the tibial nerve and its branches. Some studies have reported the location of the tibial nerve; however, textbooks and researches have not described the posterior tibial artery and the relationship between the tibal nerve and the posterior tibial artery in detail. The purpose of this study was to analyze the location of neurovascular structures and bifurcations of the nerve and artery in the ankle region based on the anatomical landmarks. Ninety feet of embalmed human cadavers were examined. All measurements were evaluated based on a reference line. Neurovascular structures were classified based on the relationship between the tibial nerve and the posterior tibial artery. The bifurcation of arteries and nerves were expressed by X- and Y-coordinates. Based on the reference line, 9 measurements were examined. The most common type I (55.6%), was the posterior tibial artery located medial to the tibial nerve. Neurovascular structures were located less than 50% of the distance between M and C from M at the reference line. The bifurcation of the posterior tibial artery was 41% in X-coordinate, -38% in Y-coordinate, and that of the tibial nerve was 48%, and -10%, respectively. Thirteen measurements and classification showed statistically significant differences between both sexes (P<0.05). It is determined the average position of neurovascular structures in the human ankle region and recorded the differences between the sexes and amongst the populations. These results would be helpful for the diagnosis and treatment of foot pain.

No MeSH data available.


Related in: MedlinePlus