2013
DOI: 10.1007/s00590-013-1343-6
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Safety profile of sural nerve in posterolateral approach to the ankle joint: MRI study

Abstract: The posterolateral approach to ankle joint is well suited for ORIF of posterior malleolar fractures. There are no major neurovascular structures endangering this approach other than the sural nerve. The sural nerve is often used as an autologous peripheral nerve graft and provides sensation to the lateral aspect of the foot. The aim of this paper is to measure the precise distance of the sural nerve from surrounding soft tissue structures so as to enable safe placement of skin incision in posterolateral approa… Show more

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Cited by 12 publications
(11 citation statements)
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“…First, the sural nerve shall be carefully protected during the operation. The sural nerve lies on the posterolateral side of the ankle under the skin, usually crossing the lower segment of the incisions from posterior to anterior, and thus shall be protected when dissecting the fat layer [ 17 , 18 ]. Second, note that the insertion of flexor hallucis longus on the fibula should be dissected and pulled medially, to reveal the posterior malleolus fractures, during which the posterior tibial vessels and nerves immediately medial to it shall be protected [ 19 ].…”
Section: Discussionmentioning
confidence: 99%
“…First, the sural nerve shall be carefully protected during the operation. The sural nerve lies on the posterolateral side of the ankle under the skin, usually crossing the lower segment of the incisions from posterior to anterior, and thus shall be protected when dissecting the fat layer [ 17 , 18 ]. Second, note that the insertion of flexor hallucis longus on the fibula should be dissected and pulled medially, to reveal the posterior malleolus fractures, during which the posterior tibial vessels and nerves immediately medial to it shall be protected [ 19 ].…”
Section: Discussionmentioning
confidence: 99%
“…In it, measurements were made from the lateral most aspect of the AT to the sural nerve to establish the safety window of the posterolateral approach to open reduction internal fixation of posterior malleolar fractures. 8 In our study, we measured both the M-L and A-P distances of the sural nerve to the AT, as these distances may provide more precise and useful information that can be used by surgeons during AT repair procedures.…”
Section: Discussionmentioning
confidence: 99%
“…Although the majority of our rupture subjects were male, the sex ratio of AT ruptures in our cohort is consistent with findings in the literature showing a higher incidence of AT ruptures in males compared to females, 14,18,23 and past studies have shown no difference in the relationship between the AT and the sural nerve by sex. 8 This was a retrospective observational study, so there may have been selection bias in only evaluating patients who received MRIs and thus may not have been representative of the general population with ruptured or nonruptured ATs.…”
Section: Discussionmentioning
confidence: 99%
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“…A more extensive exposure may be required with increased soft tissue dissection to remove small fragments or organized hematoma, risking sural nerve injury and increasing wound healing difficulties. 2,12,21,22 The posterior malleolus may be opened in a book-like manner using the intact PITFL as a hinge for removal of the blocking fragments. 4 However, an additional posteromedial incision may be required when the posterior malleolar fragment is too large, when it is difficult to open the fracture, or when the small fragments are located on the medial side.…”
mentioning
confidence: 99%