Sural nerve injury associated with neglected tendo Achilles ruptures

Fletcher, Matt D. A.; Warren, P. J.

doi:10.1136/bjsm.35.2.131

Cited by 13 publications

(7 citation statements)

References 9 publications

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“…Lee et al [16] and Carden et al [22] documented sural nerve injury in 13.33 and 7.6%, respectively. Fletcher and Warren [23] believe that the damage to the sural nerve occurs as a direct consequence of Achilles tendon rupture and it was not diagnosed and documented meticulously in the past.…”

Section: Discussionmentioning

confidence: 99%

A Combined Repair Technique for Early Neglected Achilles Tendon Ruptures

Fotiadis

Chatzisimeon

Samoladas

et al. 2007

Eur J Trauma Emerg Surg

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Section: Discussionmentioning

confidence: 99%

A Combined Repair Technique for Early Neglected Achilles Tendon Ruptures

Fotiadis

Chatzisimeon

Samoladas

et al. 2007

Eur J Trauma Emerg Surg

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“…The provocation of a painful nerve is confirmed when the provoked symptoms are changed when the neck is flexed while the modified straight leg raise position is maintained (see Figure 9). In addition, the sural nerve can be irritated by external pressure against the nerve, 201 after achilles tendon rupture or repair, 202,203 or after inversion trauma, resulting in posteror lateral ankle pain. This affliction can mimic peroneal tenosynovitis 204 and is provoked with a modified straight leg raise procedure similar to the superficial peroneal nerve, only with the ankle/foot positioned in dorsiflexion and inversion (see Figure 10).…”

Section: Diagnostic Interpretation and Managementmentioning

confidence: 99%

Diagnosis and Management of the Painful Ankle/Foot. Part 2: Examination, Interpretation, and Management

Sizer

Phelps²,

Dedrick

et al. 2003

Pain Practice

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Diagnosis, interpretation, and subsequent management of ankle/foot pathology can be challenging to clinicians. A sensitive and specific physical examination is the strategy of choice for diagnosing selected ankle/foot injuries and additional diagnostic procedures, at considerable cost, may not provide additional information for clinical diagnosis and management. Because of a distal location in the sclerotome and the reduced convergence of afferent signals from this region to the dorsal horn of the spinal cord, pain reference patterns are low and the localization of symptoms is trustworthy. Effective management of the painful ankle/foot is closely linked to a tissue-specific clinical examination. The examination of the ankle/foot should include passive and resistive tests that provide information regarding movement limitations and pain provocation. Special tests can augment the findings from the examination, suggesting compromises in the structural and functional integrity of the ankle/foot complex. The weight bearing function of the ankle/foot compounds the clinician's diagnostic picture, as limits and pain provocation are frequently produced only when the patient attempts to function in weight bearing. As a consequence, clinicians should consider this feature by implementing numerous weightbearing components in the diagnosis and management of ankle/foot afflictions. Limits in passive motion can be classified as either capsular or non-capsular patterns. Conversely, patients can present with ankle/foot pain that demonstrates no limitation of motion. Bursitis, tendopathy, compression neuropathy, and instability can produce ankle/foot pain that is challenging to diagnose, especially when they are the consequence of functional weight bearing. Numerous non-surgical measures can be implemented in treating the painful ankle/foot, reserving surgical interventions for those patients who are resistant to conservative care.

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“…Seltener kann es bei konservativer Therapie unter Anwendung eines Gipsverbandes zu einer Nervenschädigung durch lange einwirkenden Druck kommen. Der SN kann hier durch eine narbige Adhäsion an das proximale Ende der AS trahiert werden [4].…”

Section: Fallbeschreibungunclassified

“…Die minimalinvasive, perkutane Versorgung bietet demgegenüber die Vorteile geringerer Komplikationsraten, allerdings ist sie vergesellschaftet mit einem deutlich höheren Risiko einer Schädigung des N. suralis (SN) [3]. Eine chronische Läsion des SN ist auch bei unbehandelter AS-Ruptur selbst und unter konservativer Therapie beschrieben worden [4]. Symptome eines SN-Schadens treten in den meisten Fällen erst mit einer Latenz von mehreren Wochen auf.…”

Section: Introductionunclassified