Tibial nerve palsy as the presenting feature of posterior tibial artery pseudoaneurysm

Three patients who originally presented with a mass in the tarsal tunnel are described to develop an algorithm for management of the tarsal ganglion. All three patients had complications from ganglion excision, including complete division of the posterior tibial nerve, injury to the posterior tibial artery, and ganglion recurrence. The guiding principles relating to the presence of an extraneural versus an intraneural ganglion are developed. An example of a posterior tibial intraneural ganglion is presented. (J Am Podiatr Med Assoc 95(5): 459–463, 2005)

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Acute first onset of Ehlers–Danlos Syndrome type 4 with spontaneous rupture of posterior tibial artery pseudoaneurysm

Vascular ◽

10.1258/vasc.2011.cr0318 ◽

2012 ◽

Vol 21 (1) ◽

pp. 43-45 ◽

Cited By ~ 6

Author(s):

Vittorio Arici ◽

Riccardo Corbetta ◽

Luca Germano Fossati ◽

Attilio Odero

Keyword(s):

Spontaneous Rupture ◽

Premature Death ◽

Posterior Tibial Artery ◽

Syndrome Type ◽

Ehlers Danlos Syndrome ◽

Artery Pseudoaneurysm ◽

Posterior Tibial ◽

Tibial Artery ◽

Vascular Type ◽

Danlos Syndrome

Ehlers–Danlos syndrome type 4, the vascular type, is a rare, life-threatening inherited disorder of the connective tissue. Affected patients are at risk of arterial, bowel and uterine rupture during pregnancy. Generally, this syndrome remains undiagnosed until a sudden, acute presentation with organ rupture, and results in premature death, even if the patients survive the first and second major complications. An early diagnosis with genetic assays can help to plan the best treatment, which is often challenging due to the frailty of the arterial tissue. We report on a 28-year-old lady who presented with spontaneous rupture of a pseudoaneurysm of the posterior tibial artery.

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Endovascular treatment of a post-traumatic posterior tibial artery pseudoaneurysm: A case report

Turkish Journal of Vascular Surgery ◽

10.9739/tjvs.2019.309 ◽

2019 ◽

Vol 28 (2) ◽

pp. 123-126

Author(s):

Mohamed Osman

Keyword(s):

Case Report ◽

Endovascular Treatment ◽

Posterior Tibial Artery ◽

Artery Pseudoaneurysm ◽

Posterior Tibial ◽

Tibial Artery ◽

Post Traumatic

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Cadaveric Study of the Neurovascular Bundle in Tarsal Tunnel Region among Sudanese - 2020

10.14293/s2199-1006.1.sor-.ppuprts.v1 ◽

2021 ◽

Author(s):

yasser seddeg ◽

Elfarazdag Ismail

Keyword(s):

Tibial Nerve ◽

Posterior Tibial Artery ◽

Neurovascular Bundle ◽

Medial Malleolus ◽

Tarsal Tunnel ◽

Nerve Blocks ◽

Bifurcation Points ◽

Posterior Tibial ◽

Tibial Artery ◽

Displacement Osteotomy

Abstract Background: Tarsal tunnel is situated medial to the ankle lying deep to the flexor retinaculum. Within which lies the neurovascular bundle in separate compartments. This study examines the level of bifurcation points of tibial nerve and posterior tibial artery, and the location of medial and lateral plantar nerves in the tarsal tunnel. As well as the origin of the medial calcaneal nerves. Methods: This study was a descriptive observational cross sectional study. Step by step dissections of the tarsal tunnel were performed on 30 Sudanese cadavers, the contents of the tarsal tunnel were explored. Results: The tibial nerve was found to bifurcate before the the medial malleolus calcaneal axis (MMCA) in (n=4/30, 13.3%) specimens , and inside the tunnel (n=26/30, 86.7%). The branching point of the posterior tibialartery was found before the MMCA in (n=10/28, 35.7%) of specimens, at the MMCA in (n=16/28, 57.1%), and after the MMCA in (n= 2/28, 7.1%). Medial calcaneal nerves were found to be derived from the LPN plus the TN in (n=13/30, 43.3%), while in (n=6/30, 20%) were derived from LPN plus MPN plus TN. only (n=5/30, 16.7 %) were derived from LPN alone. Conclusion: anatomical knowledge of the bifurcation points of tibial nerve and posterior tibial artery is of great importance in many medical procedures like external fixation of medial malleolus fractures, medial displacement osteotomy and nerve blocks in podiatric medicine.

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