Branches of the Tibial nerve Medial calcaneal nerve innervates plantar medial heel Medial plantar nerve innervates Abductor Hallucis FHB FDB lumbricals to 2nd and 3rd toes at risk proper branch of medial plantar nerve at risk with medial-plantar approach to the tibial sesamoid Lateral plantar nerve innervates adductor hallucis quadratus plantae all interossei muscles lateral two lumbricals abductor digiti minimus (via Baxter's nerve - the first branch of LPN) Baxter`s nerve courses anterior to the medial tubersosity between the QP and FDB provides sensation to plantar lateral foot lateral fourth toe fifth toe Physical exam injury to lateral/medial plantar nerve leads to weak or absent MTP flexion (intrinsic minus) Sural Nerve Provides dorsal sensory in 4th web space (70-80% of time) Most vulnerable during extensile lateral approach to calcaneus screw placement for stress fx of proximal 5th MT Achilles tendon repair - especially percutaneous technique Deep peroneal Nerve Innervates EDB, and EHB in foot Provides sensation to the first dorsal webspace Found compressed beneath inferior retinaculum in anterior tarsal tunnel syndrome Lateral branch most vulnerable during removal of calcaneonavicular bar during approach for reduction of Lisfranc injury Injury injury leads to weak or absent EDB and EHB function this can be seen with trauma or CMT Superficial Peroneal Nerve Medial branch dorsomedial aspect of hallux most vulnerable during bunion surgery Lateral cutaneous branch emerges from deep fascia 12-15 cm proximal to tip of lateral malleolus most vulnerable with arthroscopic anterolateral portal ORIF of distal fibula fx (especially Weber C) At risk with ankle inversion injuries Saphenous Nerve Supplies sensation to medial side of foot