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The posterior tibial artery arises from the popliteal artery in the popliteal fossa. [1] It is accompanied by a deep vein, the posterior tibial vein, along its course. It passes just posterior to the medial malleolus of the tibia, but anterior to the Achilles tendon. [1] It passes into the foot deep to the flexor retinaculum of the foot. [1]
Tarsal tunnel release is a form of a nerve decompression to relieve pressure on the tibial nerve. The incision is made behind the ankle bone and then down towards but not as far as the bottom of foot. The posterior tibial nerve is identified above the ankle. It is separated from the accompanying artery and vein and then followed into the tunnel.
The tibial nerve, posterior tibial artery, posterior tibial vein, and flexor tendons travel in a bundle along this pathway through the tarsal tunnel, in the following order from anteromedial to posterolateral: Tibialis posterior tendon. [2] Flexor digitorum longus tendon. [2] Posterior tibial artery. [2] Posterior tibial vein. [1] Tibial nerve. [2]
A knee dislocation is an injury in which there is disruption of the knee joint between the tibia and the femur. [3] [4] Symptoms include pain and instability of the knee. [2] Complications may include injury to an artery, most commonly the popliteal artery behind the knee, or compartment syndrome. [3] [4] [7]
Enumerated from the medial side, the four canals which it forms transmit the tendons of the tibialis posterior and flexor digitorum longus muscles; the posterior tibial artery and tibial nerve, which run through a broad space beneath the ligament; and lastly, in a canal formed partly by the talus, the tendon of the flexor hallucis longus.
The main deep neurovascular bundle at risk is the posterior tibial artery. It lies on the posterior aspect of the tibialis posterior and flexor digitorum longus muscle, and medial to the belly of flexor hallucis longus muscle. It also gives rise to medial plantar artery and lateral plantar artery. [1]
Medial tibial stress syndrome: Pain occurs over the shin bone (the tibia) with running or other sport-related activity. [17] Fibular and tibial stress fracture: Non-displaced microscopic fracture of the fibular and tibia occurs in many athletes, especially runners, and also in non-athletes who suddenly increase their activity level. [18]
Pimenta's point is an anatomical landmark for easy location of the posterior tibial artery or tibialis posterior artery (a peripheral pulse on the inside of the ankle). An imagined line is drawn between the bony prominence of the medial malleolus and the insertion of the achilles tendon.