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The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications
Despite the fact that the superficial peroneal nerve is the only nerve in the human body that can be made visible; iatrogenic damage to this nerve is the most frequently reported complication in anterior ankle arthroscopy. One of the methods to visualize the nerve is combined ankle plantar flexion a...
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Formato: | Texto |
Lenguaje: | English |
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Springer-Verlag
2010
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855034/ https://www.ncbi.nlm.nih.gov/pubmed/20224993 http://dx.doi.org/10.1007/s00167-010-1099-z |
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author | de Leeuw, Peter A. J. Golanó, Pau Sierevelt, Inger N. van Dijk, C. Niek |
author_facet | de Leeuw, Peter A. J. Golanó, Pau Sierevelt, Inger N. van Dijk, C. Niek |
author_sort | de Leeuw, Peter A. J. |
collection | PubMed |
description | Despite the fact that the superficial peroneal nerve is the only nerve in the human body that can be made visible; iatrogenic damage to this nerve is the most frequently reported complication in anterior ankle arthroscopy. One of the methods to visualize the nerve is combined ankle plantar flexion and inversion. In the majority of cases, the superficial peroneal nerve can be made visible. The portals for anterior ankle arthroscopy are however created with the ankle in the neutral or slightly dorsiflexed position and not in combined plantar flexion and inversion. The purpose of this study was to undertake an anatomical study to the course of the superficial peroneal nerve in different positions of the foot and ankle. We hypothesize that the anatomical localization of the superficial peroneal nerve changes with different foot and ankle positions. In ten fresh frozen ankle specimens, a window, only affecting the skin, was made at the level of the anterolateral portal for anterior ankle arthroscopy in order to directly visualize the superficial peroneal nerve, or if divided, its terminal branches. Nerve movement was assessed from combined 10° plantar flexion and inversion to 5° dorsiflexion, standardized by the Telos stress device. Also for the 4th toe flexion, flexion of all the toes and for skin tensioning possible nerve movement was determined. The mean superficial peroneal nerve movement was 2.4 mm to the lateral side when the ankle was moved from 10° plantar flexion and inversion to the neutral ankle position and 3.6 mm to the lateral side from 10° plantar flexion and inversion to 5° dorsiflexion. Both displacements were significant (P < 0.01). The nerve consistently moves lateral when the ankle is manoeuvred from combined plantar flexion and inversion to the neutral or dorsiflexed position. If visible, it is therefore advised to create the anterolateral portal medial from the preoperative marking, in order to prevent iatrogenic damage to the superficial peroneal nerve. |
format | Text |
id | pubmed-2855034 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | Springer-Verlag |
record_format | MEDLINE/PubMed |
spelling | pubmed-28550342010-04-25 The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications de Leeuw, Peter A. J. Golanó, Pau Sierevelt, Inger N. van Dijk, C. Niek Knee Surg Sports Traumatol Arthrosc Ankle Despite the fact that the superficial peroneal nerve is the only nerve in the human body that can be made visible; iatrogenic damage to this nerve is the most frequently reported complication in anterior ankle arthroscopy. One of the methods to visualize the nerve is combined ankle plantar flexion and inversion. In the majority of cases, the superficial peroneal nerve can be made visible. The portals for anterior ankle arthroscopy are however created with the ankle in the neutral or slightly dorsiflexed position and not in combined plantar flexion and inversion. The purpose of this study was to undertake an anatomical study to the course of the superficial peroneal nerve in different positions of the foot and ankle. We hypothesize that the anatomical localization of the superficial peroneal nerve changes with different foot and ankle positions. In ten fresh frozen ankle specimens, a window, only affecting the skin, was made at the level of the anterolateral portal for anterior ankle arthroscopy in order to directly visualize the superficial peroneal nerve, or if divided, its terminal branches. Nerve movement was assessed from combined 10° plantar flexion and inversion to 5° dorsiflexion, standardized by the Telos stress device. Also for the 4th toe flexion, flexion of all the toes and for skin tensioning possible nerve movement was determined. The mean superficial peroneal nerve movement was 2.4 mm to the lateral side when the ankle was moved from 10° plantar flexion and inversion to the neutral ankle position and 3.6 mm to the lateral side from 10° plantar flexion and inversion to 5° dorsiflexion. Both displacements were significant (P < 0.01). The nerve consistently moves lateral when the ankle is manoeuvred from combined plantar flexion and inversion to the neutral or dorsiflexed position. If visible, it is therefore advised to create the anterolateral portal medial from the preoperative marking, in order to prevent iatrogenic damage to the superficial peroneal nerve. Springer-Verlag 2010-03-12 2010 /pmc/articles/PMC2855034/ /pubmed/20224993 http://dx.doi.org/10.1007/s00167-010-1099-z Text en © The Author(s) 2010 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. |
spellingShingle | Ankle de Leeuw, Peter A. J. Golanó, Pau Sierevelt, Inger N. van Dijk, C. Niek The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications |
title | The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications |
title_full | The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications |
title_fullStr | The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications |
title_full_unstemmed | The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications |
title_short | The course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications |
title_sort | course of the superficial peroneal nerve in relation to the ankle position: anatomical study with ankle arthroscopic implications |
topic | Ankle |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855034/ https://www.ncbi.nlm.nih.gov/pubmed/20224993 http://dx.doi.org/10.1007/s00167-010-1099-z |
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