The posterior tibial nerve is the larger of the two terminal branches of the sciatic nerve L4-S3. It leaves the popliteal fossa between the heads of medial and lateral gastrocnemius muscles and then runs below the characteristic arch of the soleus muscle. At this level the tibial nerve is lateral to popliteal vessels, while, proximally, it is close to the vessels and crosses to the medial side of the artery. Then it descends in the median plane of the fibula, between soleus and deep ankle flexor muscles tibialis posterior, flexor digitorum lon- gus, and flexor hallucis longus. At the ankle the tibial nerve runs posterior to the medial malleolus under the flexor retinaculum that forms the tarsal tunnel. The tarsal tunnel contains the tibial nerve, the tibial artery, the flexor hallucis longus tendon, the flexor digitorum longus tendon, and tibialis posterior tendon Fig.
After arising from the popliteal artery, the posterior tibial artery travels in the medial part of the posterior compartment of the leg in the fascial plane between the superficial and deep muscle groups. At its proximal end, the posterior tibial artery gives off the fibular artery, which travels in the lateral part of the posterior compartment of the leg. The fibular artery has perforating branches that pierce the intermuscular septum to enter the lateral compartment of the leg. Posterior tibial artery provides blood to the muscles of the posterior and lateral compartments of the leg and the sole of the foot.
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