Aszmann OC, Ebmer JM, Dellon AL: The cutaneous innervation of the medial ankle: an anatomic study of the saphenous, sural and tibial nerve and their clinical significance. .Foot and Ankle19::753. ,1998. .
Aszmann OC, Ebmer JM, Dellon AL: The cutaneous innervation of the medial ankle: an anatomic study of the saphenous, sural and tibial nerve and their clinical significance. .Foot and Ankle19::753. ,1998. .9840204)| false
Variations in the Origin of the Medial Calcaneal Nerve
A. Lee Dellon
A. Lee DellonProfessor of Plastic Surgery and Neurosurgery, Johns Hopkins University School of Medicine; Director of the Institute for Peripheral Nerve Surgery, Baltimore, MD. Mailing address:Suite 370, 3333 N Calvert St, Baltimore, MD 21218.
Previous anatomic studies of the medial heel region were done on embalmed human cadavers. Here, the innervation of the medial heel region was studied by dissecting living tissue with the use of 3.5-power loupe magnification during decompression of the medial ankle for tarsal tunnel syndrome in 85 feet. The medial heel was found to be innervated by just one medial calcaneal nerve in 37% of the feet, by two medial calcaneal nerves in 41%, by three medial calcaneal nerves in 19%, and by four medial calcaneal nerves in 3%. An origin for a medial calcaneal nerve from the medial plantar nerve was found in 46% of the feet. This nerve most often innervates the skin of the posteromedial arch, where it is at risk for injury during calcaneal spur removal or plantar fasciotomy. Knowledge of the variations in location of the medial calcaneal nerves may prevent neuroma formation during surgery and provide insight into the variability of heel symptoms associated with tarsal tunnel syndrome. (J Am Podiatr Med Assoc 92(2): 97-101, 2002)