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.
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Acknowledgements
The authors sincerely thank those who donated their bodies to science so that anatomical research could be performed. Results from such research can potentially increase mankind's overall knowledge that can then improve patient care. Therefore, these donors and their families deserve our highest gratitude.
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VB: Data collection, data analysis, manuscript writing; CP, MR: Data collection; MHF: Protocol development, manuscript editing; JLB: Protocol development, manuscript editing; AV: Protocol development, manuscript editing.
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Belgaid, V., Pangaud, C., Rarchaert, M. et al. Relationships of the superficial fibular nerve and sural nerve with respect to the lateral malleolus: implications for ankle surgeons. Surg Radiol Anat 44, 609–615 (2022). https://doi.org/10.1007/s00276-022-02909-8
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DOI: https://doi.org/10.1007/s00276-022-02909-8