Bruno S Pereira1,2,3, Helder Pereira4,5,6,7, Ricardo Visiedo Robles8, Andrés Pérez Rivas9, Özgür Oktay Nar10, João Espregueira-Mendes11,5,6,7,12, Xavier Martin Oliva13,14. 1. Orthopedic Surgery Department, Hospital de Braga, Sete Fontes, São Victor, 4710-243, Braga, Portugal. pereira.bac@gmail.com. 2. Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal. pereira.bac@gmail.com. 3. Facultad de Medicina, University of Barcelona, Casanova 143, 08036, Barcelona, Spain. pereira.bac@gmail.com. 4. Orthopedic Surgery Department, Centro Hospitalar Póvoa de Varzim-Vila do Conde, Unidade da Póvoa de Varzim, Largo da Misericórdia, 4490-421, Póvoa de Varzim, Portugal. 5. Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4709-057, Braga, Portugal. 6. ICVS/3Bs, PT Government Associate Laboratory, Braga, Guimarães, Portugal. 7. Dom Henrique Research Centre, Porto, Portugal. 8. Servicio COT, Grupo Hospitalario QUIRON La Coruña, A Coruña, Spain. 9. INOT (Instituto Nacional de Ortopedia y Traumatología), Montevideo, Uruguay. 10. Orthopaedics and Traumatology Department, VM Medicalpark Bursa Special Hospital, Bursa, Turkey. 11. Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal. 12. Escola de Medicina, Universidade do Minho, Braga, Portugal. 13. Orthopedic Surgery Department, Clínica Ntra. Sra. Del Remei, Carrer de l'Escorial, 148, 08024, Barcelona, Spain. 14. Facultad de Medicina, University of Barcelona, Casanova 143, 08036, Barcelona, Spain.
Abstract
PURPOSE: The aim of this study is to compare the distance from the peroneal tendons sheath to the sural nerve in different points proximally and distally to the tip of the fibula. METHODS: Ten fresh-frozen lower extremities were dissected to expose the nerves and tendons. Having the posterior tip of the fibula as a reference, the distance between the tendons sheath and the sural nerve was measured in each point with a tachometer with three independent different observers. Two measures were taken distally at 1.5 and 2 cm from fibula tip and 3 measures were performed proximally at 2, 3, and 5 cm from fibula tip. Data were described using means, standard deviations, medians, and minimum and maximum values. RESULTS: The average distance between distance between the fibula tip and sural nerve is 16.6 ± 4.4 mm. The average distance between peroneal tendons sheath and the sural nerve at 5 cm, 3 cm, and 2 cm from the proximal fibular tip was 29.6 ± 3.2 mm, 24.2 ± 3.6 mm, and 19.7 ± 2.7 mm, respectively. The average distance between the peroneal tendons sheath and the sural nerve at 2 cm and 1.5 cm distal to fibular tip was 9.1 ± 3.5 mm and 7.8 ± 3.3 mm, respectively. CONCLUSION: The distance from the peroneal tendons sheath to the sural nerve decreases from proximal to distal. As the distance between the peroneal tendons sheath and the sural nerve decreases from proximal to distal, performing the tendoscopy portal more distally would increase the risk of nerve iatrogenic injury.
PURPOSE: The aim of this study is to compare the distance from the peroneal tendons sheath to the sural nerve in different points proximally and distally to the tip of the fibula. METHODS: Ten fresh-frozen lower extremities were dissected to expose the nerves and tendons. Having the posterior tip of the fibula as a reference, the distance between the tendons sheath and the sural nerve was measured in each point with a tachometer with three independent different observers. Two measures were taken distally at 1.5 and 2 cm from fibula tip and 3 measures were performed proximally at 2, 3, and 5 cm from fibula tip. Data were described using means, standard deviations, medians, and minimum and maximum values. RESULTS: The average distance between distance between the fibula tip and sural nerve is 16.6 ± 4.4 mm. The average distance between peroneal tendons sheath and the sural nerve at 5 cm, 3 cm, and 2 cm from the proximal fibular tip was 29.6 ± 3.2 mm, 24.2 ± 3.6 mm, and 19.7 ± 2.7 mm, respectively. The average distance between the peroneal tendons sheath and the sural nerve at 2 cm and 1.5 cm distal to fibular tip was 9.1 ± 3.5 mm and 7.8 ± 3.3 mm, respectively. CONCLUSION: The distance from the peroneal tendons sheath to the sural nerve decreases from proximal to distal. As the distance between the peroneal tendons sheath and the sural nerve decreases from proximal to distal, performing the tendoscopy portal more distally would increase the risk of nerve iatrogenic injury.