Anterior Tarsal Tunnel Space
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We're focusing on the anterior extensor compartment.
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Let's talk about the anterior tarsal tunnel space.
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Some of you have watched a few vignettes on the
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tendons, but the space is formed deep boundary by
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the talus and further inferiorly by the navicular.
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So here's the navicular.
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The superficial boundary is going to be
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formed by the extensor retinaculum, which
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you might have heard about ad nauseam.
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So now let's go up a little bit higher
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and we find the vascular bundle.
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And then just lateral to the vascular
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bundle, we're going to find the nerve bundle.
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And the nerve bundle may stay as a single
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bundle, but it often divides at or two to
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three centimeters below the joint space.
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So there we actually see it
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dividing into its two bundles.
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The lateral bundle we sort of
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lose because of the curvature.
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Maybe we see a little bit of its free edge there.
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And the lateral bundle provides nerve supply
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to the extensor digitorum longus and the
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extensor hallucis, and also to the sinus tarsi.
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And a few other structures.
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It'll also give off some superficial branches.
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The medial bundle will head off medially,
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so let's go down and see if we can track it.
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There it is right there.
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There it is right there.
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And it's gonna continue to head medially
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and sit in front of the navicular headed
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towards the location of the great toe where
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it provides sensation between the first and
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second great toe and the dorsum of the foot.
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When this nerve is irritated, sometimes
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that's confused with a spine problem and
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the patient ends up with a lumbar MRI.
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That would be the deep portion or medial
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portion of the deep peroneal nerve that provides
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sensation between the first and second digits.
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
ProScan Imaging
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