Ankle arthroscopy: is preoperative marking of the superficial peroneal nerve important?

The aim of this study was to see whether preoperative marking of the superficial peroneal nerve and its branches before anterior ankle arthroscopy reduced the incidence of nerve injury compared with the available evidence reported in the literature. We reviewed 100 consecutive cases of anterior ankle arthroscopy that had been performed between February 2005 and April 2009. The medical records for all of the patients were reviewed for any documented complications related to the arthroscopic procedure. The patients were interviewed by telephone to find out if they had experienced any temporary or long-term neurologic symptoms after the surgery, and any patient with symptoms suggestive of a neurologic complication was thereafter physically examined in the clinic. A total of 96 (96%) of the patients were followed up for a mean of 15.3 (range 1 to 39) months, and the incidence of post-arthroscopy injury to the superficial peroneal nerve or its branches was 1.04% (1 out of 96 cases). Based on our observations, we believe that marking the superficial peroneal nerve and its branches before anterior ankle arthroscopy is an important and effective way to decrease the risk of iatrogenic nerve injury.