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Positional relationship between the Achilles tendon and sural nerve on ultrasound

  • Original Article–Orthopedics
  • Published:
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Abstract

Purpose

This study sought to clarify the positional relationship between the Achilles tendon and sural nerve using ultrasound.

Methods

We studied 176 legs in 88 healthy volunteers. The positional relationship between the Achilles tendon and sural nerve at heights of 2, 4, 6, 8, 10, and 12 cm proximal from the calcaneus’ proximal margin was investigated by distance and depth. Setting the X-axis (left/right) as the horizontal axis and Y-axis (depth) as the vertical axis against ultrasound images, we investigated the distance between the lateral margin of the Achilles tendon to the midpoint of the sural nerve on the X-axis. The Y-axis was split into four zones: the part behind the center of the Achilles tendon (AS), the part in front of the center of the Achilles tendon (AD), the part behind the Achilles tendon (S), and the part in front (D). We investigated the zones through which the sural nerve passed. We also studied any significant differences between the sexes and left/right legs.

Results

The mean distance on the X-axis was closest at 6 cm, with 1.1 ± 5.0 mm between them. The sural nerve’s position on the Y-axis was such that at positions more proximal than 8 cm, the sural nerve ran through zone S in most legs and moved to zone AS through heights 2–6 cm. No parameters showed significant differences between the sexes or left/right legs.

Conclusion

We presented the positional relationship between the Achilles tendon and sural nerve and suggested some measures to prevent nerve injury during surgery.

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Data availability

No data was used for the research described in the article.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, JA Toyama Kouseiren Takaoka Hospital, 5-10 Eiraku-Cho, Takaoka, 933-8555, Japan

    Tomo Hamada, Yasumitsu Toribatake, Shunpei Okamoto, Daigo Sakagoshi, Takashi Ota & Manase Nishimura

Authors
  1. Tomo Hamada
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  2. Yasumitsu Toribatake
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  3. Shunpei Okamoto
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  4. Daigo Sakagoshi
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  5. Takashi Ota
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  6. Manase Nishimura
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Corresponding author

Correspondence to Tomo Hamada.

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Conflict of interest

Tomo Hamada, Yasumitsu Toribatake, Shunpei Okamoto, Daigo Sakagoshi, Takashi Ota, and Manase Nishimura declare that they have no conflicts of interest.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of JA Toyama Kouseiren Takaoka Hospital (January 27, 2022/No. 20220127001). All participants provided written informed consent.

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Hamada, T., Toribatake, Y., Okamoto, S. et al. Positional relationship between the Achilles tendon and sural nerve on ultrasound. J Med Ultrasonics 50, 441–446 (2023). https://doi.org/10.1007/s10396-023-01312-z

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  • DOI: https://doi.org/10.1007/s10396-023-01312-z

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