Vincent Belgaid1, Corentin Pangaud1, Maxime Rarchaert1, Michel-Henri Fessy1,2,3, Jean-Luc Besse1,2, Anthony Viste4,5,6. 1. Hospices Civils de Lyon, Hôpital Lyon Sud, Chirurgie Orthopédique et Traumatologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France. 2. Univ de Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMRT_9406, Lyon, France. 3. Faculté de Médecine et Maïeutique Lyon Sud-Charles Mérieux, Laboratoire d'Anatomie, 165 Chemin du Petit Revoyet, 69921, Oullins, Cedex, France. 4. Hospices Civils de Lyon, Hôpital Lyon Sud, Chirurgie Orthopédique et Traumatologique, 165 Chemin du Grand Revoyet, 69495, Pierre-Bénite Cedex, France. Anthony.viste@chu-lyon.fr. 5. Univ de Lyon, Université Claude Bernard Lyon 1, Univ Gustave Eiffel, IFSTTAR, LBMC UMRT_9406, Lyon, France. Anthony.viste@chu-lyon.fr. 6. Faculté de Médecine et Maïeutique Lyon Sud-Charles Mérieux, Laboratoire d'Anatomie, 165 Chemin du Petit Revoyet, 69921, Oullins, Cedex, France. Anthony.viste@chu-lyon.fr.
Abstract
PURPOSE: Superficial fibular nerve (SFN) and sural nerve are at risk during osteosynthesis of the lateral malleolus. The aim of this anatomical study was to describe the relationships of the superficial fibular and sural nerves with respect to the lateral malleolus. METHODS: Nine corpses (18 ankles) were dissected, using a direct lateral approach. Measurements were recorded between the fibula and the nerves, and the pattern variations of the SFN were recorded for both right and left side to assess intra-individual variability. RESULTS: Distance between the tip of the lateral malleolus and the piercing of fascia cruris was 111 ± 26 mm for type 1 pattern, and range was 46-161 mm all types included. 78% (14 SFN) were type 1 pattern, 17% (3 SFN) were type 2 pattern, and 5% (1 SFN) were type 3 pattern. 44% (4 specimen) had a type 1 pattern SFN on one ankle and another pattern on the other ankle. The sural nerve was always observed just posterior to the lateral malleolus. CONCLUSION: This study demonstrated a great inter-individual variability especially for the SFN, but also an intra-individual variability with frequent different patterns between right and left leg. It is important to know the anatomical variations of the SFN and sural nerve to decrease the risk of intra operative nerve injury during direct lateral approach of lateral malleolus.
PURPOSE: Superficial fibular nerve (SFN) and sural nerve are at risk during osteosynthesis of the lateral malleolus. The aim of this anatomical study was to describe the relationships of the superficial fibular and sural nerves with respect to the lateral malleolus. METHODS: Nine corpses (18 ankles) were dissected, using a direct lateral approach. Measurements were recorded between the fibula and the nerves, and the pattern variations of the SFN were recorded for both right and left side to assess intra-individual variability. RESULTS: Distance between the tip of the lateral malleolus and the piercing of fascia cruris was 111 ± 26 mm for type 1 pattern, and range was 46-161 mm all types included. 78% (14 SFN) were type 1 pattern, 17% (3 SFN) were type 2 pattern, and 5% (1 SFN) were type 3 pattern. 44% (4 specimen) had a type 1 pattern SFN on one ankle and another pattern on the other ankle. The sural nerve was always observed just posterior to the lateral malleolus. CONCLUSION: This study demonstrated a great inter-individual variability especially for the SFN, but also an intra-individual variability with frequent different patterns between right and left leg. It is important to know the anatomical variations of the SFN and sural nerve to decrease the risk of intra operative nerve injury during direct lateral approach of lateral malleolus.
Authors: T Ogüt; I Akgün; H Kesmezacar; T Türker; I Uzün; S Demirci; T Marur; G Can; S M Akkin Journal: Surg Radiol Anat Date: 2004-03-13 Impact factor: 1.246