Deutsch A, Wyzykowski R J, Victoroff B N
Department of Orthopaedic Surgery, Case Western Reserve University, Cleveland, Ohio 44106, USA.
Am J Sports Med. 1999 Jan-Feb;27(1):10-5. doi: 10.1177/03635465990270010201.
A two-part study was undertaken to clarify the anatomy of the common peroneal nerve at the level of the lateral joint line and risk factors associated with arthroscopically assisted inside-out lateral meniscus repair. In part I, 70 legs in 35 preserved cadavera were dissected to evaluate the relevant anatomy of the common peroneal nerve; 7 (10%) manifested division of the common peroneal nerve into deep and superficial branches proximal to the knee joint. A cutaneous branch not previously described in the literature emanated from the common peroneal trunk in 21 of the legs (30%). In part II, arthroscopically assisted inside-out lateral meniscus repair was performed on 10 fresh-frozen cadaveric knees. Divergence between suture arms increased as suture position was sequentially posterior. Capture of a nerve branch occurred in 2 knees (20%) when posterior retraction was not used. Nerve involvement was eliminated when a retractor was employed. There was significant anatomic variability in the course and branching pattern of the common peroneal nerve at the level of the lateral joint line. During arthroscopically assisted inside-out lateral meniscus repair, risk of injuring the peroneal nerve was related to suture position because of the proximity of anatomic structures and the tendency for suture divergence with soft tissue tethering.
本研究分为两个部分，旨在阐明外侧关节线水平腓总神经的解剖结构以及关节镜辅助下由内向外外侧半月板修复相关的危险因素。在第一部分中，对35具保存的尸体的70条腿进行解剖，以评估腓总神经的相关解剖结构；7条腿（10%）表现为腓总神经在膝关节近端分为深支和浅支。21条腿（30%）的腓总神经干发出一条文献中未曾描述的皮支。在第二部分中，对10个新鲜冷冻的尸体膝关节进行关节镜辅助下由内向外外侧半月板修复。随着缝线位置依次向后，缝线臂之间的分歧增加。当不使用后牵开器时，2个膝关节（20%）出现神经分支被夹住的情况。使用牵开器后神经受累情况消除。在外侧关节线水平，腓总神经的走行和分支模式存在显著的解剖变异。在关节镜辅助下由内向外外侧半月板修复过程中，由于解剖结构接近以及缝线与软组织束缚导致缝线分歧的趋势，腓总神经损伤风险与缝线位置有关。
