Percutaneous plating of the distal tibia and fibula: risk of injury to the saphenous and superficial peroneal nerves

Journal of Orthopaedic Trauma
Amer MirzaThomas J Ellis

Abstract

To assess the risk of injury to the superficial peroneal nerve, saphenous nerve, and saphenous vein in percutaneous fixation of the distal fibula and tibia. Ten adult cadaver lower extremities were instrumented with precontoured periarticular plates for the distal tibia and fibula. Plates were inserted percutaneously along the medial distal tibia and lateral fibula. Smooth wires were inserted percutaneously into each screw hole. Dissection of the superficial peroneal nerve, saphenous nerve, and saphenous vein was performed along their respective course. The position of the neurovascular structures relative to the smooth wires was recorded. The saphenous nerve and vein had a predictable course along the medial aspect of the ankle. Both structures were injured in every specimen. This occurred consistently at 2.0 to 4.7 cm from the tip of the medial malleolus. The superficial peroneal nerve demonstrated large variance in the exit point from the lateral compartment crural fascia, exiting at an average of 11.6 cm from the tip of the lateral malleolus. Injury occurred in a single specimen at 11.5 cm from this point. The superficial peroneal nerve, saphenous nerve, and saphenous vein are at risk during percutaneous submuscular plating...Continue Reading

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Citations

Aug 1, 2013·Musculoskeletal Surgery·C IacobellisR Aldegheri
Sep 12, 2014·Current Sports Medicine Reports·James R Meadows, Jonathan T Finnoff
May 20, 2015·Journal of Clinical Orthopaedics and Trauma·Pramod SainiSamarth Mittal
Jul 14, 2012·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Jens A Halm, Tim Schepers
Dec 18, 2013·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Dominik DuscherLena Hirtler
Apr 25, 2014·Journal of Orthopaedic Surgery and Research·Hui MaBin Ye
Jan 8, 2016·Foot & Ankle International·Chao-Ching ChiangMing-Chau Chang
Mar 2, 2021·Morphologie : Bulletin De L'Association Des Anatomistes·M Relvas-SilvaP Pereira

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