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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

Comparison among studies of the most common bifurcated location of the tibial nerve.
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Figure 3: Comparison among studies of the most common bifurcated location of the tibial nerve.

Mentions: The bifurcation of the tibial nerve has been reported using the standard line [91314], but the bifurcation of the artery was not described in detail. Dellon and Mackinnon [14] reported that the bifurcation was at the standard line (55%) and that the majority of it was within 2 cm of the standard line (94%). Havel et al. [9] declared that the bifurcation occurred at the standard line in 26 feet (38%) and within 2 cm in 63 feet (93%). Most of the bifurcations were distributed at -1 to -1.9 cm according to the Bareither et al. [13] study (27%). However in this study, the location was -2 to -2.9 cm (50%) from the distal to the tip of medial malleolus. It was difficult to compare the bifurcation between the standard lines amongst the studies. However, the bifurcations in Bareither et al. [13] and this study were located more proximal side than reported by Dellon and Mackinnon [14] and Havel et al. [9] (Fig. 3). Thus, the locations to be considered during diagnosis and treatments differ among population groups.


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

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

Comparison among studies of the most common bifurcated location of the tibial nerve.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Comparison among studies of the most common bifurcated location of the tibial nerve.
Mentions: The bifurcation of the tibial nerve has been reported using the standard line [91314], but the bifurcation of the artery was not described in detail. Dellon and Mackinnon [14] reported that the bifurcation was at the standard line (55%) and that the majority of it was within 2 cm of the standard line (94%). Havel et al. [9] declared that the bifurcation occurred at the standard line in 26 feet (38%) and within 2 cm in 63 feet (93%). Most of the bifurcations were distributed at -1 to -1.9 cm according to the Bareither et al. [13] study (27%). However in this study, the location was -2 to -2.9 cm (50%) from the distal to the tip of medial malleolus. It was difficult to compare the bifurcation between the standard lines amongst the studies. However, the bifurcations in Bareither et al. [13] and this study were located more proximal side than reported by Dellon and Mackinnon [14] and Havel et al. [9] (Fig. 3). Thus, the locations to be considered during diagnosis and treatments differ among population groups.

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