Alexander M Wakker, Marisa Claassen, Michael H J Verhofstad, Theo van Walsum, Jacob J Visser, Mark G van Vledder, Hilco P Theeuwes
{"title":"腓肠神经与跟骨：影像学及解剖学研究。","authors":"Alexander M Wakker, Marisa Claassen, Michael H J Verhofstad, Theo van Walsum, Jacob J Visser, Mark G van Vledder, Hilco P Theeuwes","doi":"10.1016/j.fas.2025.04.005","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":48743,"journal":{"name":"Foot and Ankle Surgery","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The sural nerve & the calcaneus: A radiographic and anatomical study.\",\"authors\":\"Alexander M Wakker, Marisa Claassen, Michael H J Verhofstad, Theo van Walsum, Jacob J Visser, Mark G van Vledder, Hilco P Theeuwes\",\"doi\":\"10.1016/j.fas.2025.04.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>IV.</p>\",\"PeriodicalId\":48743,\"journal\":{\"name\":\"Foot and Ankle Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-04-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Foot and Ankle Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.fas.2025.04.005\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Foot and Ankle Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.fas.2025.04.005","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
The sural nerve & the calcaneus: A radiographic and anatomical study.
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.
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.
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