The sural nerve & the calcaneus: A radiographic and anatomical study.

IF 1.9 3区医学 Q2 ORTHOPEDICS

Foot and Ankle Surgery Pub Date : 2025-04-26 DOI:10.1016/j.fas.2025.04.005

Alexander M Wakker, Marisa Claassen, Michael H J Verhofstad, Theo van Walsum, Jacob J Visser, Mark G van Vledder, Hilco P Theeuwes

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引用次数: 0

Abstract

Background: The sinus tarsi approach (STA) is a commonly used minimally invasive surgical approach for the fixation of joint depression-type calcaneus fractures. As the sural nerve (SN) is particularly at risk during the STA, understanding the SN's course in relation to bony landmarks on fluoroscopic imaging is crucial.

Methods: Dissection of 19 post-mortem humans were performed to expose the SN. The SN's course was mapped relative to radiographic bony landmarks, anatomical plates for fracture fixation, and the STA incision location.

Results: The SN typically enters the cranial part of the calcaneus midway between the posterior talocalcaneal (PTC) joint and the calcaneal tuberosity. The posterior tail of the calcaneal plates were always placed under the main branch of the SN.

Conclusion: The study highlighted that the SN is always at risk during minimally invasive plate fixation for calcaneal fractures. Intra-operative fluoroscopy could be beneficial for minimizing nerve damage and enhancing surgical outcomes.

Level of evidence: IV.

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腓肠神经与跟骨：影像学及解剖学研究。

背景：跗骨窦入路是治疗关节凹陷型跟骨骨折常用的微创入路。由于在STA期间腓肠神经（SN）特别危险，因此了解腓肠神经与透视成像上的骨标志物的关系至关重要。方法：对19例死后尸体进行解剖，以暴露SN。SN的路线与x线骨标记、骨折固定的解剖钢板和STA切口位置相关。结果：典型的SN进入跟骨颅部，位于距骨后关节和跟骨结节之间。跟骨板的后尾总是位于骶椎主干的下方。结论：本研究强调了跟骨骨折微创钢板内固定时SN存在风险。术中透视可减少神经损伤，提高手术效果。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot and Ankle Surgery ORTHOPEDICS-

CiteScore

4.60

自引率

16.00%

发文量

202

期刊介绍： Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.