Ultrasound evaluation of a new surface reference line to describe sural nerve location and safe zones to consider in posterior leg approaches

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dc.contributor.authorRuiz Riquelme, Pablo
dc.contributor.authorPoggio Cano, Daniel
dc.contributor.authorSala Blanch, Xavier
dc.contributor.authorCuéllar Bernal, Daniel
dc.contributor.authorBaduell, Albert
dc.contributor.authorGarcía Elvira, Rubén
dc.contributor.authorTesta, Enrique Adrián
dc.date.accessioned2022-12-27T11:57:40Z
dc.date.available2022-12-27T11:57:40Z
dc.date.issued2022-12-26
dc.description.abstractPurpose Several authors have described methods to predict the sural nerve pathway with non-proportional numerical distances, but none have proposed a person-proportional, reproducible method with anatomical references. The aim of this research is to describe ultrasonographically the distance and crossing zone between a surface reference line and the position of the sural nerve. Methods Descriptive cross-sectional study, performed between January and April 2022 in patients requiring foot surgery who met inclusion criteria. The sural nerve course in the posterior leg was located and marked using ultrasound. Landmarks were drawn with a straight line from the medial femoral condyle to the tip of the fbula. Four equal zones were established in the leg by subdividing the distal half of the line. This way, areas based on simple anatomical proportions for each patient were studied. The distance between the marking and the ultrasound nerve position was measured in these 4 zones, creating intersection points and safety areas. Location and distances from the sural nerve to the proposed landmarks were assessed. Results One-hundred and four lower limbs, 52 left and 52 right, assessed in 52 patients were included. The shortest median distance of the nerve passage was 2.9 mm from Point 2. The sural nerve intersection was 60/104 (57.7%) in Zone B, 21/104 (20.1%) in Zone C and 19/104 (18.3%) in Zone A. Safety zones were established. Average 80.5% of coincidence in sural nerve localization was found in the distal half of the leg, in relation to the surface reference line when comparing both legs of each patient. Conclusions This study proposes a simple, reproducible, non-invasive and, for the frst time, person-proportional method, that describes the distance and location of the main areas of intersection of the sural nerve with points and zones (risk and safe zones) determined by a line guided by superfcial anatomical landmarks. Its application when surgeons plan and perform posterior leg approaches will help to avoid iatrogenic nerve injuries. Level of evidence IV.es
dc.identifier.citationRuiz-Riquelme, P., Poggio-Cano, D., Sala-Blanch, X. et al. Ultrasound evaluation of a new surface reference line to describe sural nerve location and safe zones to consider in posterior leg approaches. Knee Surg Sports Traumatol Arthrosc (2022). https://doi.org/10.1007/s00167-022-07294-8es
dc.identifier.issn1433-7347
dc.identifier.orcidhttps://orcid.org/0000-0002-3293-8189es
dc.identifier.orcidhttps://orcid.org/0000-0002-7523-9986es
dc.identifier.orcidhttps://orcid.org/0000-0001-8682-1616es
dc.identifier.orcidhttps://orcid.org/0000-0002-4459-4299es
dc.identifier.orcidhttps://orcid.org/0000-0001-6153-0011es
dc.identifier.orcidhttps://doi.org/10.1007/s00167-022-07294-8es
dc.identifier.urihttp://hdl.handle.net/20.500.12254/2638
dc.language.isoenes
dc.publisherSpringeres
dc.relation.ispartofseriesKnee Surgery, Sports Traumatology, Arthroscopy;
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.subject.otherSural nervees
dc.subject.otherUltrasonographyes
dc.subject.otherPeripheral nerve injurieses
dc.subject.otherLeg injurieses
dc.subject.otherPosterior leg and ankle approacheses
dc.titleUltrasound evaluation of a new surface reference line to describe sural nerve location and safe zones to consider in posterior leg approacheses
dc.typeArtículoes
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