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阴部皮神经与隐神经之间的联系:病例报告。

Connection between medial dorsal cutaneous nerve and saphenous nerve: case report.

机构信息

Department of Anatomy, School of Medicine, Niğde Ömer Halisdemir University, Niğde, Türkiye.

Department of Anatomy, School of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Türkiye.

出版信息

Surg Radiol Anat. 2023 Oct;45(10):1233-1237. doi: 10.1007/s00276-023-03214-8. Epub 2023 Aug 1.

DOI:10.1007/s00276-023-03214-8
PMID:37528298
Abstract

PURPOSE

There are no data on the connection of the saphenous nerve (SN), located on the medial side of the foot, with the terminal branches of the superficial fibular nerve. The aim of this study is to reveal the variation that surgeons should pay attention to for anesthesia applied in foot surgeries.

METHODS

In this study, the left foot of a 70-year-old female cadaver fixed with formalin was dissected. The distance to the medial malleolus and the incision line was recorded using digital caliper to determine the reference points in the resulting variation.

RESULTS

It was observed that a branch from the SN, which arose from the SN and proceeded anteriorly to the upper part of the medial malleolus and continued towards the dorsum of the foot, hooked with a branch from the medial dorsal cutaneous nerve (MDCN). The branches arising from this hook were distributed on the medial edge of the foot up to the proximal metatarsophalangeal joint I. The distance of this nerve connection to the medial malleolus is 91.14 mm, and the distance to the incision line is 15.76 mm.

CONCLUSIONS

It is suggested that the case presented as an unusual SN variation, which may affect the success of local anesthesia in invasive procedures to the medial part of the foot and could be considered in the evaluation of sensory loss after anteromedial surgical approach to the ankle, should be included in the classification of the cutaneous innervation pattern of the foot.

摘要

目的

目前尚无关于位于足部内侧的隐神经(SN)与腓浅神经终末支连接的相关数据。本研究旨在揭示外科医生在足部手术麻醉时应注意的变异情况。

方法

本研究对一具 70 岁女性福尔马林固定的左足进行解剖。使用数字卡尺记录距内踝和切口线的距离,以确定在变异中产生的参考点。

结果

观察到 SN 的一个分支,从 SN 向前走行到内踝的上部,然后向足部背侧延伸,与内侧背侧皮神经(MDCN)的一个分支形成钩状。该钩状分支分布于足部内侧缘,直至第一跖趾关节近端。该神经连接到内踝的距离为 91.14mm,到切口线的距离为 15.76mm。

结论

本研究提出,所呈现的病例为一种不常见的 SN 变异,可能会影响到对足部内侧侵入性手术的局部麻醉效果,在评估踝关节前内侧手术入路后感觉丧失时应考虑到这一点,并且应该被纳入足部皮肤神经支配模式的分类中。

相似文献

1
Connection between medial dorsal cutaneous nerve and saphenous nerve: case report.阴部皮神经与隐神经之间的联系:病例报告。
Surg Radiol Anat. 2023 Oct;45(10):1233-1237. doi: 10.1007/s00276-023-03214-8. Epub 2023 Aug 1.
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Surgical anatomy of the sural and superficial fibular nerves with an emphasis on the approach to the lateral malleolus.腓肠神经和腓浅神经的手术解剖,重点是外踝入路。
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[Regional anaesthesia of the foot achieved from two cutaneous points of injection: an anatomical study].[通过两个皮肤注射点实现足部区域麻醉:一项解剖学研究]
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本文引用的文献

1
The distribution pattern of the dorsal cutaneous nerves of the foot and its clinical implications.足部背侧皮神经的分布模式及其临床意义。
Anat Cell Biol. 2020 Jun 30;53(2):137-142. doi: 10.5115/acb.20.039.
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Introduction: Why Are There so Many Different Surgeries for Hallux Valgus?引言:为什么拇外翻有如此多不同的手术方式?
Foot Ankle Clin. 2018 Jun;23(2):171-182. doi: 10.1016/j.fcl.2018.01.001. Epub 2018 Mar 5.
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[Hallux valgus : Etiology, diagnosis, and therapeutic principles].[拇外翻:病因、诊断及治疗原则]
Orthopade. 2017 Mar;46(3):283-296. doi: 10.1007/s00132-017-3397-3.
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A comparison of ankle block and spinal anesthesia for foot surgery.足部手术中踝关节阻滞与脊髓麻醉的比较。
Int J Clin Exp Med. 2015 Oct 15;8(10):19388-93. eCollection 2015.
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Hallux valgus.拇外翻。
Med Clin North Am. 2014 Mar;98(2):227-32. doi: 10.1016/j.mcna.2013.10.007. Epub 2013 Dec 8.
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Saphenous nerve innervation of the medial ankle.隐神经对踝关节内侧的支配。
Local Reg Anesth. 2013 Mar 6;6:13-6. doi: 10.2147/LRA.S42603. Print 2013.
7
The saphenous nerve in foot and ankle surgery: its variable anatomy and relevance.足部和踝关节手术中的隐神经:其可变的解剖结构和相关性。
Foot Ankle Surg. 2013 Jun;19(2):76-9. doi: 10.1016/j.fas.2012.10.007. Epub 2012 Dec 27.
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The course of the distal saphenous nerve: a cadaveric investigation and clinical implications.隐神经远端的走行:尸体研究及临床意义
Iowa Orthop J. 2011;31:231-5.
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[Forefoot surgery under regional anesthesia].[区域麻醉下的前足手术]
Acta Chir Orthop Traumatol Cech. 2005;72(2):122-4.