Tryfonidis Marios, Whitfield Christopher G, Charalambous Charalambos P, Baraza Wal K, Blundell Chris, Sharp Robert J
Foot Ankle Int. 2008 Aug;29(8):842-4. doi: 10.3113/FAI.2008.0842.
There have been limited studies assessing the relative safety of lateral portals for subtalar arthroscopy in terms of their distance from the sural nerve and its branches. The aim of this cadaveric study was to assess and compare the distance of lateral subtalar arthroscopy portal sites to the sural nerve and its branches.
Twenty embalmed cadaveric lower limbs were dissected exposing the nerves and tendons and subtalar arthroscopy portals were replicated using pins. The anatomically important distances were measured with a digital caliper. Statistical analysis of the data was performed using SPSS for Windows 11.5 (SPSS Inc, Chicago, IL) using Friedman Tests and Wilcoxon Signed Ranks tests.
The median distance of the anterior and middle subtalar portals to the nearest nerve was 21.3 mm and 20.9 mm, respectively, and 11.4 mm for the posterior portal. There was no statistically significant difference between anterior and middle portals (p=0.87) but there was statistically significant difference between anterior versus posterior and middle versus posterior portals (p=0.001 in each comparison).
The anterior and middle subtalar portals were both less likely to damage important structures than the posterior subtalar portal.
The results of this study can be of value to the surgeon when planning arthroscopic procedures to the subtalar joint from the lateral approach.
关于距下关节镜外侧入路相对于腓肠神经及其分支的距离，评估其相对安全性的研究有限。本尸体研究的目的是评估和比较距下关节镜外侧入路部位与腓肠神经及其分支的距离。
解剖20具防腐处理的尸体下肢，暴露神经、肌腱，并用针复制距下关节镜入路。用数字卡尺测量重要的解剖学距离。使用适用于Windows 11.5的SPSS（SPSS公司，伊利诺伊州芝加哥）对数据进行统计分析，采用弗里德曼检验和威尔科克森符号秩检验。
距下前、中入路到最近神经的中位距离分别为21.3mm和20.9mm，后入路为11.4mm。前入路和中入路之间无统计学显著差异（p = 0.87），但前入路与后入路、中入路与后入路之间有统计学显著差异（每次比较p = 0.001）。
距下前、中入路比距下后入路损伤重要结构的可能性更小。
本研究结果对于外科医生从外侧入路计划距下关节镜手术时具有参考价值。
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