{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:30:19Z","timestamp":1787754619165,"version":"build-2784847793"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2016,3,16]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Both vascular and compression etiologies have been proposed as the source of neurologic symptoms in tarsal tunnel syndrome. Advancing the understanding of the arterial anatomy supplying the posterior tibial nerve (PTN) and its branches may provide insight into the cause of tarsal tunnel symptoms. The purpose of this study was to describe the arterial anatomy of the PTN and its branches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Sixty adult cadaveric lower extremities (thirty previously frozen and thirty fresh specimens) were amputated distal to the knee. The vascular supply to the PTN and its branches was identified, measured, and described macroscopically (the thirty previously frozen specimens, prepared using a formerly described debridement technique) and microscopically (the thirty fresh specimens, processed using the Sp\u00e4lteholz technique).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>On both macroscopic and microscopic evaluation, the PTN and the medial and lateral plantar nerves were observed to have multiple entering vessels within the tarsal tunnel. On microscopic evaluation, a vessel was observed to enter the nerve at the bifurcation of the PTN into the medial and lateral plantar nerves in twenty-two (73%) of the thirty specimens. There was a significant difference (p &lt; 0.05) in vascular density between the PTN and each of its branches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The abundant blood supply to the PTN and its branches identified in this study is consistent with observations of other peripheral nerves. This rich vascular network may render the PTN and its branches susceptible to nerve compression related to vascular congestion. The combination of vascular and structural compression may also elicit neurologic symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>Advancing the understanding of the arterial anatomy supplying the PTN and its branches may provide insight into the cause and treatment of tarsal tunnel syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.15.00787","type":"journal-article","created":{"date-parts":[[2016,3,16]],"date-time":"2016-03-16T16:19:35Z","timestamp":1458145175000},"page":"499-504","source":"Crossref","is-referenced-by-count":11,"title":["Arterial Anatomy of the Posterior Tibial Nerve in the Tarsal Tunnel"],"prefix":"10.2106","volume":"98","author":[{"given":"Mary Claire","family":"Manske","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Sports Medicine, University of Washington, Seattle, Washington"},{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen E.","family":"McKeon","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"},{"name":"Andrews Sports Medicine and Orthopaedic Center, Birmingham, Alabama"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy J.","family":"McCormick","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey E.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra E.","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"2","key":"bib1-20230714","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1177\/107110070302400205","article-title":"Outcome of surgical treatment of tarsal tunnel syndrome","volume":"24","author":"Sammarco","year":"2003","journal-title":"Foot Ankle Int."},{"key":"bib2-20230714","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1056\/NEJM196001142620202","article-title":"[Peripheral entrapment neuropathies of the lower extremity]","volume":"262","author":"Kopell","year":"1960","journal-title":"N Engl J Med."},{"issue":"3","key":"bib3-20230714","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/BF00271447","article-title":"The proximal and distal tarsal tunnel syndromes. An anatomical study","volume":"11","author":"Heimkes","year":"1987","journal-title":"Int Orthop."},{"issue":"3","key":"bib4-20230714","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1177\/107110078800900304","article-title":"Tibial nerve branching in the tarsal tunnel","volume":"9","author":"Havel","year":"1988","journal-title":"Foot Ankle."},{"key":"bib5-20230714","doi-asserted-by":"crossref","first-page":"626","DOI":"10.1001\/archsurg.1938.01190220068005","article-title":"Normal anatomy and variations of the peripheral nerves of the leg and foot","volume":"36","author":"Horwitz","year":"1938","journal-title":"Arch Surg."},{"issue":"6","key":"bib6-20230714","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1001\/archneur.1984.04210080053013","article-title":"Tibial nerve branching in the tarsal tunnel","volume":"41","author":"Dellon","year":"1984","journal-title":"Arch Neurol."},{"issue":"6","key":"bib7-20230714","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1002\/ca.22203","article-title":"Potential sites of compression of tibial nerve branches in foot: a cadaveric and imaging study","volume":"26","author":"Ghosh","year":"2013","journal-title":"Clin Anat."},{"issue":"3","key":"bib8-20230714","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.fas.2011.10.007","article-title":"Tarsal tunnel syndrome: a literature review","volume":"18","author":"Ahmad","year":"2012","journal-title":"Foot Ankle Surg."},{"issue":"3","key":"bib9-20230714","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/107110079902000312","article-title":"Tarsal tunnel syndrome: a review of the literature","volume":"20","author":"Lau","year":"1999","journal-title":"Foot Ankle Int."},{"issue":"4","key":"bib10-20230714","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/0014-4886(67)90127-6","article-title":"The effect of ischemia on nerve conduction","volume":"17","author":"Fox","year":"1967","journal-title":"Exp Neurol."},{"issue":"7","key":"bib11-20230714","doi-asserted-by":"crossref","first-page":"938","DOI":"10.2106\/00004623-197557070-00011","article-title":"Structure and function of the intraneural microvessels as related to trauma, edema formation, and nerve function","volume":"57","author":"Lundborg","year":"1975","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib12-20230714","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/S0749-0712(21)00708-3","article-title":"The pathophysiology of nerve compression","volume":"8","author":"Lundborg","year":"1992","journal-title":"Hand Clin."},{"issue":"2","key":"bib13-20230714","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/0026-2862(86)90050-6","article-title":"Reduced nerve blood flow in edematous neuropathies: a biomechanical mechanism","volume":"32","author":"Myers","year":"1986","journal-title":"Microvasc Res."},{"issue":"1","key":"bib14-20230714","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/0266-7681(91)90143-C","article-title":"Effects of compression and devascularisation on ulnar nerve function. A quantitative study of regional blood flow and nerve conduction in monkeys","volume":"16","author":"Ogata","year":"1991","journal-title":"J Hand Surg Br."},{"issue":"5","key":"bib15-20230714","first-page":"221","article-title":"[Motor nerve conduction velocity in normal and diabetic subjects: effect of repeated periods of ischemia]","volume":"54","author":"Ruess","year":"1973","journal-title":"Arch Phys Med Rehabil."},{"issue":"1","key":"bib16-20230714","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/S0363-5023(81)80003-2","article-title":"Effects of graded compression on intraneural blood blow. An in vivo study on rabbit tibial nerve","volume":"6","author":"Rydevik","year":"1981","journal-title":"J Hand Surg Am."},{"issue":"4","key":"bib17-20230714","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.jocn.2009.07.110","article-title":"Effects of graded mechanical compression of rabbit sciatic nerve on nerve blood flow and electrophysiological properties","volume":"17","author":"Yayama","year":"2010","journal-title":"J Clin Neurosci."},{"issue":"4","key":"bib18-20230714","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1177\/1753193408090107","article-title":"The effects of repetitive compression on nerve conduction and blood flow in the rabbit sciatic nerve","volume":"35","author":"Yoshii","year":"2010","journal-title":"J Hand Surg Eur Vol."},{"key":"bib19-20230714","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/00003086-198503000-00028","article-title":"The effect of surgical dissection on regional blood flow to the ulnar nerve in the cubital tunnel","volume":"193","author":"Ogata","year":"1985","journal-title":"Clin Orthop Relat Res."},{"key":"bib20-20230714","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1097\/00003086-197311000-00022","article-title":"Variations in the arteries of the median nerve. With special considerations on the ischemic factor in the carpal tunnel syndrome (CTS)","volume":"97","author":"Pecket","year":"1973","journal-title":"Clin Orthop Relat Res."},{"issue":"1","key":"bib21-20230714","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1007\/s12565-013-0194-x","article-title":"The intrinsic arterial vascularity and morphology of the median nerve within the carpal tunnel: a microscopic study","volume":"89","author":"Perumal","year":"2014","journal-title":"Anat Sci Int."},{"issue":"3","key":"bib22-20230714","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1016\/0363-5023(93)90086-I","article-title":"The extrinsic blood supply of the ulnar nerve at the elbow: an anatomic study","volume":"18","author":"Prevel","year":"1993","journal-title":"J Hand Surg Am."},{"issue":"1","key":"bib23-20230714","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S1058-2746(99)90048-4","article-title":"The extraneural and intraneural arterial anatomy of the ulnar nerve at the elbow","volume":"8","author":"Yamaguchi","year":"1999","journal-title":"J Shoulder Elbow Surg."},{"issue":"3","key":"bib24-20230714","first-page":"310","article-title":"Blood supply of the median nerve in the carpal tunnel","volume":"15","author":"Zbrodowski","year":"1983","journal-title":"Hand."},{"issue":"4","key":"bib25-20230714","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1177\/1071100714559271","article-title":"Arterial anatomy of the tibialis posterior tendon","volume":"36","author":"Manske","year":"2015","journal-title":"Foot Ankle Int."},{"issue":"2","key":"bib26-20230714","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1097\/00000542-199302000-00015","article-title":"The role of focal nerve ischemia and Wallerian degeneration in peripheral nerve injury producing hyperesthesia","volume":"78","author":"Myers","year":"1993","journal-title":"Anesthesiology."},{"issue":"6 Pt 1","key":"bib27-20230714","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1016\/S0363-5023(85)80163-5","article-title":"Median artery in carpal tunnel syndrome","volume":"10","author":"Barfred","year":"1985","journal-title":"J Hand Surg Am."},{"issue":"5","key":"bib28-20230714","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/S0363-5023(88)80135-7","article-title":"Persistent median artery as a cause of pronator syndrome","volume":"13","author":"Jones","year":"1988","journal-title":"J Hand Surg Am."},{"key":"bib29-20230714","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1001\/archneurpsyc.1945.02300100057006","article-title":"Blood supply of the sciatic nerve and its popliteal divisions in man","volume":"54","author":"Sunderland","year":"1945","journal-title":"Arch Neurol Psychiatry."},{"key":"bib30-20230714","first-page":"355","article-title":"Die Arterien der Intervertebralganglien und der Cerebrospinalnerven des Menschen","volume":"15","author":"Tonkoff","year":"1898","journal-title":"Internat Monatschr f Anat u Physiol."},{"key":"bib31-20230714","first-page":"393","article-title":"Die Arterien der Nerven","volume":"7","author":"Bartholdy","year":"1897","journal-title":"Morphol Arb."},{"issue":"5","key":"bib32-20230714","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1177\/107110079701800508","article-title":"Vascular supply of nerves in the tarsal tunnel","volume":"18","author":"Flanigan","year":"1997","journal-title":"Foot Ankle Int."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201603160-00009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:30:06Z","timestamp":1787751006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201603160-00009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,16]]},"references-count":32,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.15.00787","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3,16]]}}}