Department of Anatomy, School of Medicine, Niğde Ömer Halisdemir University, Niğde, Türkiye.
Department of Anatomy, School of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Türkiye.
Surg Radiol Anat. 2023 Oct;45(10):1233-1237. doi: 10.1007/s00276-023-03214-8. Epub 2023 Aug 1.
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.
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.
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.
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.
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。
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。
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。
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。