The medial calcaneal branches arise from the posterior tibial artery just above or within the tarsal tunnel, curving posteriorly and inferiorly to supply the medial heel skin, periosteum of the calcaneus, and intrinsic heel pad structures. They are the primary blood supply to the heel.
Medial calcaneal branch compression within the tarsal tunnel contributes to Baxter neuropathy (inferior calcaneal nerve entrapment). These arterial branches are assessed during tarsal tunnel decompression. Compromised calcaneal blood supply in diabetic patients predisposes to heel ulceration and calcaneal osteomyelitis.
Impaired perfusion through calcaneal branches in peripheral vascular disease or diabetic angiopathy, predisposing to pressure ulceration and deep infection at the heel.
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