Risk of Injury to the Sural Nerve during Posterolateral Approach to the Distal Tibia : An Ultrasound Simulation Study - Alexander Zayachkowski (Autor); Ewa Mizia (Autor); Krzysztof Tomaszewski (Autor); Marios Loukas (Autor); Piotr Chomicki‐Bindas (Autor); Przemysław Pękala (Autor); Wojciech Marchewka (Autor) (2018)
10.1002/ca.23205
https://onlinelibrary.wiley.com/doi/10.1002/ca.23205
Oryginalny artykuł naukowy
When surgeons operate on the foot and ankle, the most common complicationthat may arise is injury of the cutaneous nerves. The sural nerve (SN) is potentially at risk of being injured when treating fractures involving the distal tibia using the p osterolateral approach. The aim of this study was to evaluate how differences in length and position of the surgical treatment of fractures involving the distal tibia can affect the risk of SN injury. The study involved 40 healthy volunteers (n580 lower limbs). Ultrasound simulation of each potential surgical incision site was used to locate the SN and to assess the risk of injury. The study showed that the SN predominantly travels more posteriorly at levels more proximal from the tip of the lateral malleolus. At these more proximal points of the SN’s course, it was proven that there was an overall increased incidence of iatrogenic injury to the SN in incisions made closer to the Achilles tendon. Based on these results, a quasi 3 dimensional figure was created showing the anatomical structures of this region to identify areas at high risk for SN injury. By revealing how length and position of the surgical incision can influence the risk of SN injury, we hope to provide information to surgeons on the optimal technique to avoid iatrogenic SN injury while operating on the distal tibia via a posterolateral approach.
Keywords: nauki medyczne