Posterior tibial artery

Last revised by Jordan Southi on 5 May 2024

The posterior tibial artery (PTA) is one of the 2 branches of the tibioperoneal trunk in the lower leg and provides oxygenated blood to the posterior compartments of the leg and plantar surface of the foot. It is accompanied by the posterior tibial vein, along its course.

The posterior tibial artery originates from the inferior margin of popliteus muscle. It runs inferomedially and runs through the posterior compartment of the leg. It enters the foot by passing posterior to the medial malleolus. Midway from the malleolus to the calcaneal tubercle, it divides into the terminal branches.

Midway between malleolus and calcaneal tubercle it divides into medial and lateral plantar arteries, within the tarsal tunnel.

The following branches arise from the posterior tibial artery and supply structures of the posterior leg and sole of the foot:

  • circumflex fibular artery: supplies proximal fibula

  • nutrient artery of the tibia: supplies tibia bone

  • muscular arteries: supply soleus and the deep posterior compartment of the leg

  • perforating arteries: usually five, supply the skin and fascia of the posterior leg

  • communicating artery: forms an anastomosis with the fibular artery

  • medial malleolar artery: anastomoses with the anterior medial malleolar branch of the anterior tibial artery to supply the skin over the medial ankle

  • calcaneal artery: supplies skin over calcaneal tendon, calcaneus and muscles of medial sole of foot

  • medial plantar artery (terminal branch): supplies the medial side of the foot, abductor hallucis and flexor digitorum brevis, supplies digital branch to big toe

  • lateral plantar artery (terminal branch): crosses the sole obliquely and laterally, supplies skin of sole of foot, supplies lateral foot and continues to form the plantar arch, which supplies the metatarsal arteries

  • posterior tibial artery aplasia: the posterior tibial arteries are absent and there is compensatory hyperplasia of the peroneal arteries 3

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