Saito A, Kikuchi S
Department of Orthopaedic Surgery, Fukushima Medical College, Fukushima City, Japan.
Foot Ankle Int. 1998 Nov;19(11):748-52. doi: 10.1177/107110079801901107.
Ankles from 100 cadavers were dissected to evaluate the risk of nerve injury from an arthroscopic procedure. A total of 65 cadavers (104 ankles) were examined to assess the course of the peroneal nerve, and 35 cadavers (77 ankles) were examined for the saphenous nerve (SN). In 82% of specimens, the superficial peroneal nerve ran between the lateral border of the talocrural joint and the peroneus tertius tendon at the talocrural joint level, where the anterolateral portal was placed. Therefore, the superficial peroneal nerve was at high risk for injury with anterolateral portal placement. At the anteromedial portal site, between the medial border of the talocrural joint and the tibialis anterior tendon, the SN coursed an average of 6 +/- 5 mm medial to the medial border of the talocrural joint. SNs in this area were all terminal branches; therefore, anteromedial portal placement avoids nerve injury.
解剖了100具尸体的踝关节，以评估关节镜手术造成神经损伤的风险。共检查了65具尸体（104个踝关节）以评估腓总神经的走行，35具尸体（77个踝关节）用于检查隐神经（SN）。在82%的标本中，腓浅神经在距小腿关节水平位于距小腿关节外侧缘与第三腓骨肌腱之间，此处为前外侧入路的位置。因此，在前外侧入路时，腓浅神经有较高的损伤风险。在前内侧入路部位，在距小腿关节内侧缘与胫骨前肌腱之间，隐神经走行于距小腿关节内侧缘内侧平均6±5mm处。该区域的隐神经均为终末支；因此，前内侧入路可避免神经损伤。
