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Tibial nerve branching pattern and compatibility of branches for the deep fibular nerve

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Abstract

Purpose

In individuals who develop drop foot due to nerve loss, several methods such as foot-leg orthosis, tendon transfer, and nerve grafting are used. Nerve transfer, on the other hand, has been explored in recent years. The purpose of this study was to look at the tibial nerve’s branching pattern and the features of its branches in order to determine the suitability of the tibial nerve motor branches, particularly the plantaris muscle motor nerve, for deep fibular nerve transfer.

Methods

There were 36 fixed cadavers used. Tibial nerve motor branches were observed and measured, as were the lengths, distributions, and thicknesses of the common fibular nerve and its branches at the bifurcation region.

Result

The motor branches of the tibial nerve that supply the soleus muscle, lateral head, and medial head of the gastrocnemius were studied, and three distinct forms of distribution were discovered. The motor branch of the gastrocnemius medial head was commonly observed as the first branch to divide, and it appeared as a single root. The nerve of the plantaris muscle was shown to be split from many origins. When the thickness and length of the motor branches measured were compared, the nerve of the soleus muscle was determined to be the most physically suited for neurotization.

Conclusion

In today drop foot is very common. Traditional methods of treatment are insufficient. Nerve transfer is viewed as an application that can both improve patient outcomes and hasten the patient’s return to society. The nerve of the soleus muscle was shown to be the best candidate for transfer in our investigation.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. School of Medicine, Department of Anatomy, Ankara University, Sihhiye, Ankara, 06100, Turkey

    Mehmet Yilmaz, Yigit Gungor, Ayhan Comert, Tulin Sen Esmer & Ali Firat Esmer

  2. Gulhane Faculty of Medicine, Department of Anatomy, University of Health Sciences Turkey, Ankara, Turkey

    Necati Salman

Authors
  1. Mehmet Yilmaz
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  2. Yigit Gungor
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Contributions

All authors contributed to the study conception and design. All authors wrote the main manuscript text, M.Y. prepared figures. M.Y. and A.F.E. performed the dissections. All authors reviewed the manuscript.

Corresponding author

Correspondence to Mehmet Yilmaz.

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Ethics approval and informed consent

This is a cadaveric and radiological study, and all cadavers were supplied from a donated institution with subjects giving written informed consent for the use of samples in scientific studies. All the performed procedures in this study that involved cadavers followed the ethical standards of the Institutional Review Board and the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Cadaveric data were collected after approval from the Ankara University ethics committee (approval date and number: 25.11.2020 - İ10-646-20).

Consent to participate

Informed consent was obtained from all subjects included in the study.

Consent to publish

The authors affirm that human research participants provided informed consent for publication of the images as figures.

Competing interests

All authors certify no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. The authors declare that they have no conflicts of interest.

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Yilmaz, M., Gungor, Y., Salman, N. et al. Tibial nerve branching pattern and compatibility of branches for the deep fibular nerve. Surg Radiol Anat 46, 413–424 (2024). https://doi.org/10.1007/s00276-024-03329-6

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