Department of Orthopaedic Surgery, Soonchunhyang University Hospital Bucheon, 170, Jomaru-ro, Wonmi-gu, Bucheon-si 14584, Republic of Korea.
Department of Orthopedics, Manjok Clinic, 178, Jibeom-ro, Suseong-gu, Daegu 42208, Republic of Korea.
Medicina (Kaunas). 2023 Jun 8;59(6):1109. doi: 10.3390/medicina59061109.
: The arthroscopic Broström procedure is a promising treatment for chronic ankle instability. However, little is known regarding the location of the intermediate superficial peroneal nerve at the level of the inferior extensor retinaculum; knowledge about this location is important for procedural safety. The purpose of this cadaveric study was to clarify the anatomical relationship between the intermediate superficial peroneal nerve and the sural nerve at the level of the inferior extensor retinaculum. : Eleven dissections of cadaveric lower extremities were performed. The origin of the experimental three-dimensional axis was defined as the location of the anterolateral portal during ankle arthroscopy. The distances from the standard anterolateral portal to the inferior extensor retinaculum, sural nerve, and intermediate superficial peroneal nerve were measured using an electronic digital caliper. The location of inferior extensor retinaculum, the tract of sural nerve, and intermediate superficial peroneal nerve were checked using average and standard deviations. For the statistical analyses, data are presented as average ± standard deviation, and then they are reported as means and standard deviations. Fisher's exact test was used to identify statistically significant differences. : At the level of the inferior extensor retinaculum, the mean distances from the anterolateral portal to the proximal and distal intermediate superficial peroneal nerve were 15.9 ± 4.1 (range, 11.3-23.0) mm and 30.1 ± 5.5 (range, 20.8-37.9) mm, respectively. The mean distances from the anterolateral portal to the proximal and distal sural nerve were 47.6 ± 5.7 (range, 37.4-57.2) mm and 47.2 ± 4.1 (range, 41.0-51.8) mm), respectively. : During the arthroscopic Broström procedure, the intermediate superficial peroneal nerve may be damaged by the anterolateral portal; the proximal and distal parts of the intermediate superficial peroneal nerve were located within 15.9 and 30.1 mm, respectively, at the level of the inferior extensor retinaculum in cadavers. These areas should be considered danger zones during the arthroscopic Broström procedure.
关节镜下 Broström 手术是治疗慢性踝关节不稳定的一种有前途的治疗方法。然而，对于下伸肌支持带水平中间浅层腓浅神经的位置知之甚少；了解该位置对于程序安全很重要。本尸体研究的目的是阐明下伸肌支持带水平中间浅层腓浅神经与腓肠神经之间的解剖关系。 ：共进行了 11 例尸体下肢解剖。实验三维轴的原点定义为踝关节镜检查时前外侧入路的位置。使用电子数字卡尺测量标准前外侧入路至下伸肌支持带、腓肠神经和中间浅层腓浅神经的距离。下伸肌支持带、腓肠神经和中间浅层腓浅神经的位置使用平均值和标准差进行检查。对于统计分析，数据以平均值±标准差表示，然后以平均值和标准差表示。Fisher 精确检验用于确定统计学上的显著差异。 ：在下伸肌支持带水平，从前外侧入路到近端和远端中间浅层腓浅神经的平均距离分别为 15.9 ± 4.1（范围，11.3-23.0）mm 和 30.1 ± 5.5（范围，20.8-37.9）mm。从前外侧入路到近端和远端腓肠神经的平均距离分别为 47.6 ± 5.7（范围，37.4-57.2）mm 和 47.2 ± 4.1（范围，41.0-51.8）mm）。 ：在关节镜下 Broström 手术中，前外侧入路可能会损伤中间浅层腓浅神经；在尸体中，中间浅层腓浅神经的近侧和远侧部分分别位于下伸肌支持带水平的 15.9 和 30.1mm 处。这些区域在关节镜下 Broström 手术中应视为危险区域。
