Which nerve is commonly affected in tarsal tunnel syndrome?

• A. Tibial
• B. Fibular (peroneal) nerve
• C. Sural nerve
• D. Saphenous nerve

Answer: (A)

Compression within the tarsal tunnel behind the medial malleolus most often affects the tibial nerve, which travels through that fibro-osseous canal with the posterior tibial vessels and then divides into the medial and lateral plantar nerves in the sole. Because the tibial nerve supplies most intrinsic foot muscles and provides sensation to the plantar surface of the foot and toes, its compression there produces pain, numbness, and paresthesias on the sole (often the heel) and can weaken plantar intrinsic muscles. The other nerves listed don’t run through the tarsal tunnel: the fibular (peroneal) nerve runs laterally around the fibular head and supplies different regions, the sural nerve is a sensory nerve to the lateral/posterior foot, and the saphenous nerve supplies the medial leg/foot. So the nerve commonly affected in tarsal tunnel syndrome is the tibial nerve.