Skip to main content
SpringerLink
Log in

The distance from the peroneal tendons sheath to the sural nerve at the posterior tip of the fibula decreases from proximal to distal

  • ANKLE
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study is to compare the distance from the peroneal tendons sheath to the sural nerve in different points proximally and distally to the tip of the fibula.

Methods

Ten fresh-frozen lower extremities were dissected to expose the nerves and tendons. Having the posterior tip of the fibula as a reference, the distance between the tendons sheath and the sural nerve was measured in each point with a tachometer with three independent different observers. Two measures were taken distally at 1.5 and 2 cm from fibula tip and 3 measures were performed proximally at 2, 3, and 5 cm from fibula tip. Data were described using means, standard deviations, medians, and minimum and maximum values.

Results

The average distance between distance between the fibula tip and sural nerve is 16.6 ± 4.4 mm. The average distance between peroneal tendons sheath and the sural nerve at 5 cm, 3 cm, and 2 cm from the proximal fibular tip was 29.6 ± 3.2 mm, 24.2 ± 3.6 mm, and 19.7 ± 2.7 mm, respectively. The average distance between the peroneal tendons sheath and the sural nerve at 2 cm and 1.5 cm distal to fibular tip was 9.1 ± 3.5 mm and 7.8 ± 3.3 mm, respectively.

Conclusion

The distance from the peroneal tendons sheath to the sural nerve decreases from proximal to distal. As the distance between the peroneal tendons sheath and the sural nerve decreases from proximal to distal, performing the tendoscopy portal more distally would increase the risk of nerve iatrogenic injury.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Brandes CB, Smith RW (2000) Characterization of patients with primary peroneus longus tendinopathy: a review of twenty-two cases. Foot Ankle Int 21:462–468

    Article  CAS  PubMed  Google Scholar 

  2. Bravo-Gimenez B, Garcia-Lamas L, Jimenez-Diaz V, Llanos-Alcazar LF, Vila-Rico J (2013) Peroneal tendoscopy: our experience. Rev Esp Cir Ortop Traumatol 57:268–275

    CAS  PubMed  Google Scholar 

  3. Cicchetti DV (1994) Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess 6:284–290

    Article  Google Scholar 

  4. Cychosz CC, Phisitkul P, Barg A, Nickisch F, van Dijk CN, Glazebrook MA (2014) Foot and ankle tendoscopy: evidence-based recommendations. Arthroscopy 30:755–765

    Article  PubMed  Google Scholar 

  5. Drizenko A, Demondion X, Luyckx F, Mestdagh H, Cassagnaud X (2004) The communicating branches between the sural and superficial peroneal nerves in the foot: a review of 55 cases. Surg Radiol Anat 26:447–452

    Article  CAS  PubMed  Google Scholar 

  6. Guillo S, Archbold P, Perera A, Bauer T, Sonnery-Cottet B (2014) Arthroscopic anatomic reconstruction of the lateral ligaments of the ankle with gracilis autograft. Arthrosc Tech 3:e593–e598

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kennedy JG, van Dijk PA, Murawski CD, Duke G, Newman H, DiGiovanni CW et al (2016) Functional outcomes after peroneal tendoscopy in the treatment of peroneal tendon disorders. Knee Surg Sports Traumatol Arthrosc 24:1148–1154

    Article  PubMed  Google Scholar 

  8. Lawrence SJ, Botte MJ (1994) The sural nerve in the foot and ankle: an anatomic study with clinical and surgical implications. Foot Ankle Int 15:490–494

    Article  CAS  PubMed  Google Scholar 

  9. Lui TH, Tse LF (2015) Peroneal tendoscopy. Foot Ankle Clin 20:15–25

    Article  PubMed  Google Scholar 

  10. Marmotti A, Cravino M, Germano M, Del Din R, Rossi R, Tron A et al (2012) Peroneal tendoscopy. Curr Rev Musculoskelet Med 5:135–144

    Article  PubMed  PubMed Central  Google Scholar 

  11. Petersen W, Bobka T, Stein V, Tillmann B (2000) Blood supply of the peroneal tendons: injection and immunohistochemical studies of cadaver tendons. Acta Orthop Scand 71:168–174

    Article  CAS  PubMed  Google Scholar 

  12. Sammarco VJ (2009) Peroneal tendoscopy: indications and techniques. Sports Med Arthrosc Rev 17:94–99

    Article  PubMed  Google Scholar 

  13. Scholten PE, van Dijk CN (2006) Tendoscopy of the peroneal tendons. Foot Ankle Clin 11:415–420

    Article  PubMed  Google Scholar 

  14. Tryfonidis M, Whitfield CG, Charalambous CP, Baraza WK, Blundell C, Sharp RJ (2008) The distance between the sural nerve and ideal portal placements in lateral subtalar arthroscopy: a cadaveric study. Foot Ankle Int 29:842–844

    Article  PubMed  Google Scholar 

  15. van Dijk CN (2006) Hindfoot endoscopy. Foot Ankle Clin 11:391–414

    Article  PubMed  Google Scholar 

  16. van Dijk CN, Kort N (1998) Tendoscopy of the peroneal tendons. Arthroscopy 14:471–478

    Article  PubMed  Google Scholar 

  17. van Dijk PA, Madirolas FX, Carrera A, Kerkhoffs GM, Reina F (2016) Peroneal tendons well vascularized: results from a cadaveric study. Knee Surg Sports Traumatol Arthrosc 24:1140–1147

    Article  PubMed  PubMed Central  Google Scholar 

  18. Vega J, Golanó P, Batista JP, Malagelada F, Pellegrino A (2013) Tendoscopic procedure associated with peroneal tendons. Tech Foot Ankle Surg 12:39–48

    Article  Google Scholar 

  19. Vega J, Golano P, Dalmau A, Viladot R (2011) Tendoscopic treatment of intrasheath subluxation of the peroneal tendons. Foot Ankle Int 32:1147–1151

    Article  PubMed  Google Scholar 

Download references

Funding

The authors declare that there was no funding of this study.

Author information

Authors and Affiliations

  1. Orthopedic Surgery Department, Hospital de Braga, Sete Fontes, São Victor, 4710-243, Braga, Portugal

    Bruno S. Pereira

  2. Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal

    Bruno S. Pereira & João Espregueira-Mendes

  3. Orthopedic Surgery Department, Centro Hospitalar Póvoa de Varzim-Vila do Conde, Unidade da Póvoa de Varzim, Largo da Misericórdia, 4490-421, Póvoa de Varzim, Portugal

    Helder Pereira

  4. Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, 4709-057, Braga, Portugal

    Helder Pereira & João Espregueira-Mendes

  5. ICVS/3Bs, PT Government Associate Laboratory, Braga, Guimarães, Portugal

    Helder Pereira & João Espregueira-Mendes

  6. Orthopedic Surgery Department, Clínica Ntra. Sra. Del Remei, Carrer de l’Escorial, 148, 08024, Barcelona, Spain

    Xavier Martin Oliva

  7. Facultad de Medicina, University of Barcelona, Casanova 143, 08036, Barcelona, Spain

    Bruno S. Pereira & Xavier Martin Oliva

  8. Servicio COT, Grupo Hospitalario QUIRON La Coruña, A Coruña, Spain

    Ricardo Visiedo Robles

  9. Dom Henrique Research Centre, Porto, Portugal

    Helder Pereira & João Espregueira-Mendes

  10. Escola de Medicina, Universidade do Minho, Braga, Portugal

    João Espregueira-Mendes

  11. INOT (Instituto Nacional de Ortopedia y Traumatología), Montevideo, Uruguay

    Andrés Pérez Rivas

  12. Orthopaedics and Traumatology Department, VM Medicalpark Bursa Special Hospital, Bursa, Turkey

    Özgür Oktay Nar

Authors
  1. Bruno S. Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Helder Pereira
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ricardo Visiedo Robles
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andrés Pérez Rivas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Özgür Oktay Nar
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. João Espregueira-Mendes
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Xavier Martin Oliva
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed substantially to conception and design, or acquisition of data, or analysis and interpretation of data; drafted the article or revised it critically for important intellectual content; provided the final approval of the version to be published; and agreed to act as guarantor of the work (ensuring that questions related to any part of the work are appropriately investigated and resolved).

Corresponding author

Correspondence to Bruno S. Pereira.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

No ethical approval was required for this study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pereira, B.S., Pereira, H., Robles, R.V. et al. The distance from the peroneal tendons sheath to the sural nerve at the posterior tip of the fibula decreases from proximal to distal. Knee Surg Sports Traumatol Arthrosc 27, 2852–2857 (2019). https://doi.org/10.1007/s00167-019-05438-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-019-05438-x

Keywords

Search

Navigation