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The tarsal tunnel is a fibro-osseous canal found in the medial aspect of the ankle.
- roof: flexor retinaculum
- from the tip of the medial malleolus to the medial calcaneal process and plantar aponeurosis
- floor: medial surfaces of the tibia, talus and calcaneus 1, 2
From anterior to posterior:
- tibialis posterior tendon
- flexor digitorum longus tendon
- posterior tibial neurovascular bundle
- flexor hallucis longus tendon
A mnemonic to remember the order is Tom, Dick and Very Nervous Harry or Tom Doth Vex All Nervous Housemaids.
The tarsal tunnel is divided by fibrous septae joining the flexor retinaculum to the calcaneus, forming four separate compartments - one for each of the tendons and one for the neurovascular bundle 1-3.
The flexor retinaculum is continuous distally with plantar aponeurosis and proximally with the deep fascia of the leg.
- variable level of bifurcation of the tibial nerve either in, proximal or distal to the tarsal tunnel
- variable level of bifurcation of the posterior tibial artery in the tarsal tunnel
- 1. Erickson SJ, Quinn SF, Kneeland JB et-al. MR imaging of the tarsal tunnel and related spaces: normal and abnormal findings with anatomic correlation. AJR Am J Roentgenol. 1990;155 (2): 323-8. AJR Am J Roentgenol (citation) - Pubmed citation
- 2. Rosenberg ZS, Beltran J, Bencardino JT. From the RSNA Refresher Courses. Radiological Society of North America. MR imaging of the ankle and foot. Radiographics. 2000;20 Spec No : S153-79. Radiographics (link) - Pubmed citation
- 3. Rosse C, Gaddum-Rosse P. Hollinshead's textbook of anatomy. Lippincott Williams & Wilkins. (1997) ISBN:0397512562. Read it at Google Books - Find it at Amazon