Compression of the tibial nerve by the tendinous leading-edge of the soleus is rare but under recognized. The tibial nerve is decompressed by dividing the soleus arch found deep within the lower leg. The surgical approach involves proceeding between the lateral and medial gastrocnemius muscles. The soleus muscle is then identified deep to the gastrocnemius muscles, at which the tibial nerve is identified proximal to this muscle. The tibial nerve dives deep to the soleus arch, at which the compression point is found.
Standard 110414
Extended 110414
POSITION
Prone.
INCISION
A curved incision between the lateral and medial gastrocnemius muscles.
REFERENCES
- Mastaglia FL. Tibial nerve entrapment in the popliteal fossa. Muscle Nerve. 2000 Dec;23(12):1883-6. PMID: 11102915.
- Iida T, Kobayashi M. Tibial nerve entrapment at the tendinous arch of the soleus: a case report. Clin Orthop Relat Res. 1997 Jan;(334):265-9. PMID: 9005922.
- Mastaglia FL, Venerys J, Stokes BA, Vaughan R. Compression of the tibial nerve by the tendinous arch of origin of the soleus muscle. Clin Exp Neurol. 1981;18:81-5. PMID: 6926395.
Disclosure: No authors have a financial interest in any of the products, devices, or drugs mentioned in this production or publication.