Tibial nerve


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Clinical significance of Tibial Nerve block

Tarsal Tunnel Syndrome

Peripheral neuropathy related to compression of the Tibial nerve and it’s branches


  • Medial Plantar Nerve
  • Lateral Plantar Nerve
  • Calcaneal Branch (variable anatomy and may arises proximal  or distal to the Flexor retinaculum)

Tarsal Tunnel Syndrome- Impingement

  • The branch may be missed with decompression
  • In addition, impingement does not always occur, at the flexor retinaculum, but may occur anywhere in the 1 of the 3 fibrous tunnels in which the nerves run after they branch off. 

Tarsal Tunnel Syndrome

Diagnosis

  • MRI- Gold Standard for Space Occupying Lesion
  • Ultrasound
  • EMG-  Increased duration of motor conduction, reduced amplitude of tibial nerve

Tarsal Tunnel Syndrome

Treatment

  • NSAIDs, custom 
  • Custom Orthotics
  • Physical Therapy
  • Injections
  • Surgery

References

and Interesting Articles

  • Peripheral Nerve Neurosurgery, p 91-95,edited by Thomas  Wilson, Lynda J-S Yang
  • https://en.wikipedia.org/wiki/De_Quervain_syndrome
  • AF Tallia DA Cardone.  Diagnostisc and therapeutic injection of the shoulder region. Am Fam Physician 2003 Mar 15; 67 (6):1271-8
  • https://radiopaedia.org/articles/iliotibial-band-syndrome?lang=us

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