• Anatomy and Cell Biology
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• v.56 no.4
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• pp.415-420
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• 2023

The tibial nerve is a branch of the sciatic nerve, which innervates the legs and feet. Anatomical variations of this nerve at the ankle are commonly found. The variation of the tibial nerve in its branching point and cross-sectional area (CSA) at the ankle is commonly related to clinical condition such as foot neuropathy. Knowledge of these variations can support the clinician in making appropriate clinical decisions. This review aims at providing knowledge on the anatomical variations of tibial nerve at ankle, as well as its clinical correlation. This review outlined the variation of the terminal branching point and CSA of the tibial nerve at the ankle in cadaveric and clinical studies.

• Archives of Reconstructive Microsurgery
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• v.10 no.1
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• pp.12-17
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• 2001

Recovery of nerve injury is conditioned by various factors including physical state, injured site, cause of injury, and neurorrhaphy Many researchers have reported on regeneration of nerve using end to side neurorrhaphy. The purpose of this study was to examine regeneration of nerve in various conditioned side to side neurorrhaphy. Total of 25 male Sprague-Dawley rats weighing 220 to 250 gm were divided into five groups of five rats each. The group 1, sham group, composed of dissection only without nerve transaction. The group 2, control group, composed of nerve division only without neurorrhaphy or sural nerve graft. The group 3 composed of one segmental sural nerve graft between the tibial and peroneal nerve after division. Group 4 had two segment graft, and the group 5 with three segment graft, each segment being 6mm long and 5 mm apart. The side to side neurorrhaphy was performed between peroneal nerve and tibial nerve using segmental sural nerve graft in rats. We exposed the sciatic nerve, tibial nerve, peroneal nerve, and sural nerve on left side with prone position. The peroneal nerve was cut on the bifurcation site from tibial nerve and the side to side epineurial neurorrhaphy was performed between peroneal nerve and tibial nerve through 6 mm sural nerve segment graft with 11-0 nylon under operating microscope. The electromyography and the weight from ipsilateral tibialis anterior muscle was performed at one month after neurorrhaphy Peroneal and tibial nerve was examined at distal and proximal to the neurorrhaphy site by methylene blue stain under light microscope for histologic appearance. The number of nerve fibers were counted using the image analyzer. Statistically, both in electromyography and number of nerve fibers, the differences in values between the groups were significant.

• Journal of Veterinary Clinics
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• v.15 no.1
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• pp.178-179
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• 1998

In a 2-month pregnant cow, tibial nerve paralysis occurred. The hock joint is overflexed and the fetlock is partially flexed since one month. After treatment with adequate beddings anti-inflammatory ointment and electrolyte solution during 4 weeks is recovered completely.

• The Korean Journal of Pain
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• v.34 no.1
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• pp.124-131
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• 2021

Background: Sciatic nerve injury due to intramuscular injection (SNIII) is still a health problem. This study aimed to determine whether there is a correlation between neuropathic pain and electrodiagnostic findings in SNIII. Methods: Patients whose clinical and electrodiagnostic findings were compatible with SNIII participated in this retrospective cohort study. Compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes of the sural, superficial peroneal, peroneal, and tibial nerves were graded from 1 to 4. Leeds assessment of neuropathic symptoms and signs scale (LANSS) was applied to all patients. Results: Forty-eight patients were included in the study, 67% of whom had a LANSS score ≥ 12. Sural SNAP amplitude abnormalities were present in 8 (50%) out of 16 patients with a LANSS score < 12, and 28 (87.5%) out of 32 patients with a LANSS score ≥ 12, with significant differences between the groups (P = 0.011). There was a positive correlation between the LANSS score and the sural SNAP amplitude grading (P = 0.001, r = 0.476). A similar positive correlation was also found in the LANSS score and the tibial nerve CMAP amplitude grading (P = 0.004, r = 0.410). Conclusions: This study showed a positive correlation between the severity of tibial nerve CMAP/sural SNAP amplitude abnormality and LANSS score in SNIII. Neuropathic pain may be more common in SNIII patients with sural nerve SNAP amplitude abnormality.

• Anatomy and Cell Biology
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• v.56 no.4
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• pp.566-569
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• 2023

Knowledge of anatomical variations is important so as to avoid potential iatrogenic injury or misdiagnosis on imaging. Here we report an unusual finding and relationship between the tibial nerve and popliteal vein. During the routine dissection of an adult cadaver, it was noted that a branch of the tibial nerve in the popliteal fossa pierced the most distal part of the popliteal vein. This unusual finding is described and relevant reports in the literature discussed. Our hopes are that such a report might help surgeons avoid injury to such a fenestrated popliteal vein and the tibial nerve branch traveling through it therefore decreasing patient morbidity.

• The Journal of Korean Orthopaedic Ultrasound Society
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• v.6 no.1
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• pp.15-19
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• 2013

In General, popliteal cyst found in children does not present a symptom and also it rarely causes a complication. The researcher observed an entrapment of tibial nerve and popliteal artery in a child with popliteal cyst without intra-articular lesion, and treated it by using early decompression and prolotherapy, which is presented in this study with literature review.

• Journal of Korean Foot and Ankle Society
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• v.12 no.2
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• pp.216-219
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• 2008

Tarsal tunnel syndrome is a complex of symptoms resulting from the compression of the posterior tibial nerve or its branches. Many studies have done on etiologic agents. We reported two cases of tarsal tunnel syndrome secondary to the varicosis of posterior tibial vein. Symptoms were relieved after excision of the varicosis, neurolysis and reposition of posterior tibial nerve.

• Journal of Acupuncture Research
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• v.19 no.1
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• pp.175-188
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• 2002

Objective : The effects of SP6(Sanyinjiao, 三陰交) acupuncture stimulation on bladder parasympathetic nerve activity (PNA), tibial nerve activity (TNA) as well as blood pressure were examined in anesthetized rats and the results are as follows. Methods : The parasympathetic nerve leading to the bladder was exposed retroperitoneally, and the tibial nerve in the hindlimb was exposed through inguinal area. PNA and TNA were recorded using a bipolar platinum-iridium wire electrode and it was connected to preamplifier. Blood pressure was measured using cannula that was inserted into femoral artery and was recorded with blood pressure sensor that is connected with transducer amplifier. The mean value of all parameters measured for 30 seconds before the stimulation was expressed as 100%. An acupuncture needle was inserted into the SP6 region to a depth of 4 mm. Results : Under intact state (IS), acupuncture stimulation for 120 seconds induced significant increase of PNA which was accompanied with decrease of blood pressure. At the same time, TNA showed temporary increase only with acupuncture stimulation. In 4 mg/kg of naloxone-administrated state (NAS), significant decrease of PNA was seen and it was accompanied with increase of blood pressure. TNA also showed temporary increase only with acupuncture stimulation under the NAS just like the IS. Conclusion : consider that SP6(Sanyinjiao, 三陰交) acupuncture stimulation activated parasympathetic nerve and caused vasodilation to lead into the diuresis, but naloxone reversed the effect of acupuncture for antidiuresis.

• Archives of Plastic Surgery
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• v.33 no.6
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• pp.695-699
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• 2006

Purpose: In the 1990s, skin island flap supplied by the vascular axis of the sensitive superficial nerves had been introduced. For example, neurocutaneous flaps supplied by the vascular axis of the sural nerve and saphenous nerve have been used. But the flap supplied by the vascular axis of superficial peroneal nerve has not been used commonly. Because there have been few anatomical reports about the superficial peroneal nerve accessory artery(SPNAA), we could not apply the neurocutaneous flap supplied by SPNAA. The aim of this study is to investigate the anatomy of SPNAA, number and location of its perforators, and septocutaneous perforators from the anterior tibial artery in anterior intermuscular septum. Methods: So, we dissected a total of eight cadavers. Measurements were made of the positions of the dissected arteries and perforators from the head of the fibula. Results: In all cadavers the superior lateral peroneal artery was originated from the anterior tibial artery and contributed SPNAA. Arising from the anterior tibial artery an average of 5.63 cm inferior to the fibular head, it varied from 10 cm to 16 cm in length. SPNAA gave off an average of 4.38 perforators to supply lateral aspect. In one case the inferior lateral peroneal artery was present and arose from the anterior tibial artery 18 cm inferior to the fibular head. There were an average of 3.38 direct septocutaneous perforators from the anterior tibial artery. Conclusion: Septocutaneous perforators from SPNAA mainly exist from proximal 1/6 to 3/5 of lower leg. In the distal 1/3 of lower leg where the accessory artery was disappeared, exist mainly direct septocutaneous perforators from the anterior tibial artery. Our results can be helpful to applications of the neurocutaneous flap using SPNAA or fasciocutaneous flap based on direct septocutaneous perforators.

• The Korean Journal of Pain
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• v.9 no.1
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• pp.232-234
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• 1996

For surgical Treatment of spastic deformities of the foot, selective peripheral neurotomies were introduced. These neurotomies utilize microsurgical techniques and intraoperative electrical stimulation for better identification of the function of the fascicles constituting the nerve. Selectivity is required to supress the excess of spasticity without excessive weakening of motor strength and without producing exaggerated amyotrophy. To achieve this goal, minimum one fourth of the motor fibers must be preserved. Neurotomies may be indicated when spasticity is localized to muscle or muscle groups supplied by a single or a few peripheral nerves that are easily accessible. To help the surgeon decide if neurotomy is appropriate, temporary local anesthetic block of the nerve with bupivacaine can be useful. Such a test can determine if articular limitations result from spasticity, musculotendinous contractures, or articular ankyloses because only spasticity is decreased by the test. In additon, these tests give the patient a chance to appreciate what to expect from the operation.