Tibial Nerve Anatomy

This is a high tibial nerve injury. The tibial nerve, the larger terminal branch of the sciatic, is at risk with knee dislocation in the popliteal fossa. The deficit fits: loss of plantarflexion (gastrocnemius-soleus), inversion (tibialis posterior) and toe flexion, loss of foot intrinsics, and an insensate sole because the tibial nerve supplies plantar sensation via the medial and lateral plantar nerves. I would document the vascular status carefully (knee dislocation threatens the popliteal artery), perform a full neurovascular examination, and obtain electrodiagnostics in due course. The insensate sole has implications for protective sensation, ulceration risk and, historically, limb-salvage decisions - though an insensate sole alone is no longer treated as an absolute indication for amputation. Management is initially supportive (foot protection, bracing) with nerve reconstruction considered for failure to recover.