PubMed · 7288074
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T M DeLauro, R J Giorgini, S Rosen. 1981. Podiatric microsurgery.. https://doi.org/10.7547/87507315-71-10-560
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BACKGROUND: The deep veins of the leg and their associated perforating veins provide the major conduits for the return of blood from the legs to the heart. In health intrinsic valves maintain a one-way flow of blood from distal to proximal leg. OBJECTIVE: To describe and illustrate the different deep veins, their relationship to each other, and to the superficial venous system. Of particular interest is the demonstration of the deep plantar plexus and its relationship to the anterior and posterior tibial veins and to the greater and lesser saphenous veins. The valvular system, which protects them from the effects of gravity, is also illustrated. METHODS: The various deep veins as well as their tributaries and perforating veins are described in detail and illustrated with simple line drawings. These depictions help clarify the relationships between the paired veins and the higher single veins. RESULTS: Hopefully this unified approach to the various groups of deep veins will allow a better understanding of their form and function. CONCLUSIONS: The deep venous system is an integrated group of veins beginning in the deep venous plexus of the foot and terminating in the lower pelvis. Following contraction of the foot, calf, and thigh muscles the blood flows from a multitude of high pressure veins to a single low pressure vein.
Anatomic variations in tibial nerve branches may help explain discrepancies between clinical examination and electrophysiologic tests as to the location of neuronal lesions. Dissection of 20 cadaveric feet (10 pair) along the course of the tibial nerve and its branches confirmed that it bifurcates within 2 cm of the medio-malleolar-calcaneal axis in 90% (18/20) and that it gives off frequent small branches with its accompanying vascular structures. Unlike other studies, however, we found that 60% had multiple calcaneal branches off the tibial nerve and that 20% evidenced previously undescribed accessory innervation to the abductor hallucis muscle from other than the medial plantar nerve.