Danzhu Guo1, Danqing Guo2, Richard Harrison1, Logan McCool3, Hao Wang4, Brionn Tonkin3, Michel Kliot5. 1. BayCare Clinic Pain & Rehab Medicine, Aurora/BayCare Health, BayPark 2401 Holmgren Way, Green Bay, WI, 54304, USA. 2. BayCare Clinic Pain & Rehab Medicine, Aurora/BayCare Health, BayPark 2401 Holmgren Way, Green Bay, WI, 54304, USA. tctrpaper@yahoo.com. 3. Department of Rehabilitation Medicine Division of PM&R, University of Minnesota, 420 Delaware St. SE MMC 297, Minneapolis, MN, 55455, USA. 4. Guilford Orthopedics and Sports Medicine Center, 1915 Lendew Street, Greensboro, NC, 27408, USA. 5. Department of Neurosurgery, Stanford University, 300 Pasteur Dr, Palo Alto, CA, 94304, USA.
Abstract
BACKGROUND: After successful applications of the ultra-minimally invasive thread transecting technique (Guo Technique) for both thread carpal tunnel release and thread trigger finger release, we hypothesized that this technique could be used for superficial peroneal nerve release in the lower leg by selective crural fasciectomy. This study is aimed at testing the operative feasibility of performing the thread superficial peroneal nerve release (TSPNR) procedure in cadavers. METHODS: The TSPNR procedure was performed on 15 fresh frozen cadaveric lower-extremity specimens under ultrasound guidance. All cadaveric specimens were dissected and visually assessed immediately after the procedures. RESULTS: All 15 legs demonstrated a complete transection of the crural fasciae along the course of the superficial peroneal nerve (SPN) including where it penetrated and traversed the crural fascia. There was no evidence of any iatrogenic damage to the neurovascular bundle or adjacent tendons. The average operating time was less than 20 min. CONCLUSION: This cadaveric study demonstrated that the technique of TSPNR was accurate, reliable, and feasible while causing no injury to adjacent neurovascular structures and avoiding having to make a skin incision. Further studies are warranted to verify the results of this study before implementing this new technique in the clinical setting.
BACKGROUND: After successful applications of the ultra-minimally invasive thread transecting technique (Guo Technique) for both thread carpal tunnel release and thread trigger finger release, we hypothesized that this technique could be used for superficial peroneal nerve release in the lower leg by selective crural fasciectomy. This study is aimed at testing the operative feasibility of performing the thread superficial peroneal nerve release (TSPNR) procedure in cadavers. METHODS: The TSPNR procedure was performed on 15 fresh frozen cadaveric lower-extremity specimens under ultrasound guidance. All cadaveric specimens were dissected and visually assessed immediately after the procedures. RESULTS: All 15 legs demonstrated a complete transection of the crural fasciae along the course of the superficial peroneal nerve (SPN) including where it penetrated and traversed the crural fascia. There was no evidence of any iatrogenic damage to the neurovascular bundle or adjacent tendons. The average operating time was less than 20 min. CONCLUSION: This cadaveric study demonstrated that the technique of TSPNR was accurate, reliable, and feasible while causing no injury to adjacent neurovascular structures and avoiding having to make a skin incision. Further studies are warranted to verify the results of this study before implementing this new technique in the clinical setting.