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Tibial Nerve

nervus tibialis (cursus completus)

The tibial nerve descends through the popliteal fossa between the two heads of gastrocnemius, passes deep to the soleus at the tendinous arch, and runs with the posterior tibial artery through the deep posterior compartment to the tarsal tunnel. It supplies gastrocnemius, soleus, plantaris, popliteus, tibialis posterior, flexor digitorum longus, and flexor hallucis longus before dividing at the ankle into medial and lateral plantar nerves.

Region: Lower Leg

Clinical Relevance

Clinical Notes

The tibial nerve is the most commonly injured nerve in knee dislocation, where its fixation to the popliteal fossa makes it vulnerable to traction during vascular injury. Tibial nerve palsy produces loss of plantarflexion, toe flexion, and plantar sensation. Tarsal tunnel syndrome is entrapment of the tibial nerve at the medial ankle under the flexor retinaculum. The nerve is assessed by the Tinel sign at the tarsal tunnel and electrodiagnostically by plantar nerve conduction studies.

Pathology

Common Injuries & Conditions

Tibial Nerve Palsy

Complete tibial nerve injury producing loss of plantarflexion, intrinsic foot muscle paralysis, and plantar sensory loss, resulting in a calcaneovalgus deformity and neuropathic ulceration at pressure points.

Tarsal Tunnel Syndrome

Tibial nerve compression under the flexor retinaculum producing plantar burning, Tinel sign at the medial ankle, and intrinsic foot weakness, managed by decompression when conservative treatment fails.