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Distal Conduction Blocks
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
The tibial nerve divides into its terminal branches, the medial and lateral plantar nerves, at the level of the tendo calcaneus. The medial plantar nerve, accompanied by the medial plantar artery, supplies the medial part of the sole, while the lateral plantar nerve supplies the skin covering the fifth toe and the lateral half of the fourth toe (Figure 2.64E and F).
Lower Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The anterior tibial artery crosses the ankle joint, and its name changes to dorsalis pedis artery that supplies the dorsum of the foot. It gives rise to the arcuate artery that in turn gives rise to the dorsal metatarsal arteries (Plate 5.9). The dorsalis pedis artery also gives rise to the lateral tarsal artery—which joins the lateral end of the arcuate artery to complete an arterial arch—and to the deep plantar artery—which passes between the 1st and 2nd metatarsal bones to enter the sole of the foot to form an anastomosis with the deep plantar arch formed mainly by the lateral plantar artery (Plate 5.16). The lateral plantar artery arises, together with the medial plantar artery, from the posterior tibial artery, and gives rise to the deep plantar arch that in turn gives rise to common and proper plantar digital arteries. Lastly, the fibular artery runs on the posterior side of the leg to give rise to the perforating branch of the fibular artery, which pierces the interosseus membrane just above the ankle joint to anastomose with the anterior tibial artery (Plate 5.11).
Neuroanatomy overview
Published in Michael Y. Wang, Andrea L. Strayer, Odette A. Harris, Cathy M. Rosenberg, Praveen V. Mummaneni, Handbook of Neurosurgery, Neurology, and Spinal Medicine for Nurses and Advanced Practice Health Professionals, 2017
Medial plantar nerve Accompanies the medial plantar arterySupplies the flexor digitorum brevis and the abductor hallucisHas digital cutaneous branches supplying the medial 3 1/2 toes, plantar
Reconstruction of the distal lower leg and foot sole with medial plantar flap: a retrospective study in one center
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Zheng-Qiang Cang, Xiao-Dong Ni, Yuan Xu, Min Wang, Qian Wang, Si-Ming Yuan
The pedicle is constituted by the medial plantar artery and its venae comitantes and the cutaneous branch of the medial plantar nerve [23–25]. The medial plantar artery is not the dominant blood supply source of the plantar, and it plays a relatively minor role in the blood flow of the foot because the blood flow of the deep plantar arch mainly comes from the lateral plantar artery and branches of the dorsalis pedis artery [20]. This artery’s sacrifice will not affect the prognosis of the plantar. On the other hand, the medial plantar artery has sufficient diameter to ensure good blood supply of the flap [23]. Thus, we removed the superfluous soft tissue and got a slender vascular pedicle that had a high flexibility to rotate the flap. No flap had difficulty in rotation during the operation, even though some of the patients had the distal lower leg defect. No patient complained of bloated pedicle after operation. This advantage is particularly evident in the repair of distal lower leg defect when compared with sural flaps. Herlin, in his study of patients who underwent ankle defect reconstruction using the sural flap, reported a major ankle bulking [11].