Duscher Dominik, Wenny Raphael, Entenfellner Johanna, Weninger Patrick, Hirtler Lena
Department for Systematic Anatomy, Center for Anatomy and Cell Biology, Medical University of Vienna, Vienna, Austria; Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medcine, California, United States of America.
Clin Anat. 2014 May;27(4):653-8. doi: 10.1002/ca.22347. Epub 2013 Dec 17.
Three nerves innervate the skin in the foot and ankle region: the saphenous, sural, and superficial peroneal nerves. Because they are close to the medial and lateral malleoli, these nerves are at significant risk during orthopedic interventions. The aims of this study were to investigate the distal courses of the three cutaneous nerves of the ankle and to determine their exact relationships with easily identifiable bony landmarks. Ten freshly frozen and 40 embalmed lower extremities of adults were dissected. The positions of the superficial peroneal, sural, and saphenous nerves were determined using reference lines based on easily palpable osseous landmarks. The frequencies and distributions of all three nerves and their branches were converted into absolute numbers. A danger zone for each nerve was established on the basis of the distribution of crossings between the nerves and the different reference lines. Determination of the exact orientation of the nerves around the ankle should help minimize the nerve injury rate during surgical approaches in this area. Using this easily translatable new grid system, the course and danger zones of each cutaneous nerve around the ankle can be estimated clinically.
隐神经、腓肠神经和腓浅神经。由于这些神经靠近内、外踝，在骨科手术中它们面临着显著风险。本研究的目的是调查踝关节三条皮神经的远端走行，并确定它们与易于识别的骨性标志的确切关系。解剖了10例新鲜冷冻的和40例防腐处理的成人下肢。基于易于触及的骨性标志，使用参考线确定腓浅神经、腓肠神经和隐神经的位置。将所有三条神经及其分支的频率和分布转换为绝对数量。根据神经与不同参考线交叉的分布情况，为每条神经确定一个危险区域。确定神经在踝关节周围的确切走向应有助于降低该区域手术入路时的神经损伤率。使用这种易于转换的新网格系统，每条皮神经在踝关节周围的走行和危险区域可在临床上进行估计。
