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. 2007 Jul;41(7):456-8; discussion 458.
doi: 10.1136/bjsm.2006.031328. Epub 2007 Mar 8.

Anatomy of the sural nerve in a computer-assisted model: implications for surgical minimal-invasive Achilles tendon repair

Musa Citak  1 , Karsten Knobloch, Knut Albrecht, Christian Krettek, Tobias Hufner
Affiliations

Anatomy of the sural nerve in a computer-assisted model: implications for surgical minimal-invasive Achilles tendon repair

Musa Citak et al. Br J Sports Med. 2007 Jul.

Abstract

Background: Sural nerve injuries are an evident risk especially of minimal-invasive surgical Achilles tendon repair. However, detailed anatomical studies focusing on the relationship of the sural nerve with the Achilles tendon at various levels are scarce, even pending in two planes.

Aim: To determine the position and course of the sural nerve in relation to the Achilles tendon in two planes after trans-section and computer-assisted determination.

Methods: The exact course of the sural nerve was determined in 10 cadavers (55.3 years, 19-89 years), using a computer-assisted method in two planes (transversal/sagittal).

Results: The sural nerve crossed the Achilles tendon at 11 (8.7-12.4) cm proximal to the tuber calcanei. The distance between the lateral crossing and the proximal musculotendineus junction was 35 (20-58) mm. Starting from the tuber calcanei, the distance was 2/2 mm (transversal/sagittal plane) at 11 cm proximal to the tuber calcanei, 4/4 mm at 10 cm proximal, 5/6 mm at 9 cm, 8/10 mm at 5 cm and 11/18 mm at the tuber calcanei.

Conclusion: In the lateral crossing region of the sural nerve and the lateral proximal Achilles tendon 9-12 cm proximal to the tuber calcanei, a close relationship of both anatomical structures can be visualised using computer-assisted measurements; caution is suggested to prevent sural nerve entrapment in either open or percutaneous Achilles tendon repair.

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Conflict of interest statement

Competing interests: None declared.

References

    1. Ma G W C, Griffith T G. Percutaneous repair of acute closed ruptured Achilles tendon: a new technique. Clin Orthop 1977128247–255. - PubMed
    1. Cretnik A, Kosanovic M, Smrkolj V. Percutaneous versus open repair of the ruptured Achilles tendon. Am J Sports Med 2005331369–1379. - PubMed
    1. Sutherland A, Maffulli N. A modified technique of percutaneous repair of ruptured Achilles tendon. Oper Orthop Traumat 19997288–295.
    1. Winter E, Weise K, Weller S.et al Surgical repair of Achilles tendon rupture. Comparison of surgical with conservative treatment. Arch Orthop Trauma Surg 1998117364–367. - PubMed
    1. Lawrence S J, Botte M J. The sural nerve in the foot and ankle: an anatomic study with clinical and surgical implications. Foot Ankle Int 199415490–494. - PubMed