Anatomic characteristics and clinic significance of the medial calcaneal nerve

Objective: To provide anatomic evidence for choosing medial calcaneal nerve (MCN) as recipient cutaneous nerve to rebuild heel sensation. Methods: We chose 20 adult cadavers' lower limbs, dissected the MCNs, observed their original sites, shapes, courses and distribution, and measured the perpendicular distance from original sites of MCNs from tibial nerve, original sites of their branches to the tip of medial malleolus, and the external diameters of their main trunks and branches. Results: The frequency of the MCN was 95% in this array. All the MCNs arose from the tibial nerve at 3. 3 cm up the horizontal plane of the tip of medial malleolus. They sent out anterior branches and posterior branches from 0. 3 cm below the horizontal plane of the tip of medial malleolus on average. The anterior branch dominated the cutaneous sensation of the anterior part of the medial calcaneal and heel weight loading field, while the posterior branch dominated the sensation of the posterior and median part. The shape of MCNs, main trunks, anterior branches and posterior branches was like circular cylinder. At the origination, the external diameter of the MCN, the anterior branch and the posterior branch was 1.58, 1.13 and 0. 90 mm on average, respectively. Conclusion: The anatomical position of MCN is relatively constant, and its external diameter is suitable. The initiation is not close to the heel weight loading area. Its anatomic characteristics meet the requirements of sensation recovery of the heel, especially the heel weight loading field.