scholarly journals Identifying the Emergence of the Superficial Peroneal Nerve through Deep Fascia on Ultrasound and by Dissection: Implications for Regional Anaesthesia in Foot and Ankle Surgery

2018 ◽  
Author(s):  
James Bowness ◽  
Katie Turnbull ◽  
Alasdair Taylor ◽  
Jayne Halcrow ◽  
Fraser Chisholm ◽  
...  
2021 ◽  
Vol 14 (2) ◽  
pp. e235675
Author(s):  
Muhammad Nouman Baig ◽  
Ben Murphy ◽  
Ciaran M Hurley ◽  
Stephen Kearns

The ankle is a region crowded with multiple neurovascular and musculotendinous structures. We describe a case of a rare neurological complication following ankle surgery.


1996 ◽  
Vol 17 (2) ◽  
pp. 85-88 ◽  
Author(s):  
Cobi Lidor ◽  
Reginald L. Hall ◽  
James A. Nunley

Painful neuromatas in the foot and around the ankle can be difficult to treat. Five patients of clinically and histologically proven neuromas underwent centrocentral union with autologous transplantation. Three patients had previous toe amputations involving multiple operations. One patient had failed multiple operative treatments for Morton's neuroma in his 3rd web space. One patient had a neuroma in his superficial peroneal nerve caused by a gun shot wound. All patients but one showed definitive subjective and objective improvement after centrocentral union with the interposed autologous nerve graft. The patient with “recurrent” Morton's neuroma had the least improvement. This technique can be recommended as an alternative for the prevention of painful stump neuromata.


2016 ◽  
Vol 6 (2) ◽  
Author(s):  
Majed Alrowaili

A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status.


1996 ◽  
Vol 17 (9) ◽  
pp. 573-575 ◽  
Author(s):  
James D. Michelson ◽  
Mark Perry

A clinical study was undertaken to ascertain the utility and complication rate of proximal calf tourniquet use for foot and ankle surgery. The surgical and clinical records of 446 patients undergoing foot and ankle surgery between March 1992 and December 1994 were examined for details pertaining to intraoperative tourniquet use and postoperative evidence of neurologic or vascular complications. All patients who had surgery performed under tourniquet control were included in the study. A total of 454 limbs were operated on: 8 patients underwent bilateral surgical procedures. The patients comprised 172 men and 274 women. The average age was 48.9 (±16.0 SD) years. Surgery was completed in one tourniquet period in 435 cases (95.8%) and in two periods of tourniquet inflation in 19 cases (4.2%). The average duration of tourniquet ischemia was 49.2 minutes (±30.7 SD) for one tourniquet period and 131.1 minutes (±46.0 SD) for two tourniquet periods. No postoperative compromise to either neurologic or vascular function was detected. Specifically, no alteration in peroneal nerve function was seen. We conclude that a calf tourniquet placed proximally with adequate cast padding is a safe and effective method to achieve a bloodless surgical field for foot and ankle surgery.


2005 ◽  
Vol 26 (11) ◽  
pp. 942-946 ◽  
Author(s):  
Hulya Ucerler ◽  
'Z. Asli Aktan Ikiz

Background: Although the sensory branches of the superficial peroneal nerve (SPN) have different anatomical variations that are of clinical importance, little is known about their anatomic courses, branching patterns, or relationships to palpable osseous landmarks. 1 , 3 A detailed knowledge is necessary for surgical exposures about the foot and ankle, arthroscopic procedures, ankle block anesthesia, and SPN block for leg venography. Methods: Thirty lower cadaver limbs were dissected to assess the anatomic properties and the variations of the sensory branches of the SPN. Results: Three distinct branch patterns were determined. In Type 1 (63.3%), the nerve penetrated the crural fascia 80.15 ± 17.80 mm proximal to the intermalleolar line and then divided into the intermediate dorsal cutaneous nerve (IDCN) and the medial dorsal cutaneous nerve (MDCN) (classic type). In Type 2 (26.7%), the IDCN and MDCN arose independently from the SPN. In Type 3 (10%), the SPN penetrated the crural fascia 101.14 ± 70.27 mm proximal to the intermalleolar line as a single branch. This single branch had a similar course to the MDCN. Measurements in this study were obtained from palpable bony reference landmarks. Conclusion: Detailed knowledge about the SPN, IDCN, and the MDCN may decrease the damage to these nerves during operative procedures near the foot and ankle.


1989 ◽  
Vol 17 (3) ◽  
pp. 336-339 ◽  
Author(s):  
C. J. Sparks ◽  
T. Higeleo

Combined tibial and common peroneal nerve anaesthesia was used for foot and ankle surgery in fifty-six adults. Where necessary, the saphenous nerve was also blocked. A calibrated constant current nerve stimulator was used to localise the nerves in the popliteal fossa. Using lignocaine 1%, an opioid premedication, but no other sedation or top-up injection, 60% of the blocks were successful. If a patient felt pain at incision or during surgery, the block was recorded as a failure.


2015 ◽  
Vol 105 (2) ◽  
pp. 150-159 ◽  
Author(s):  
Maria Tzika ◽  
George Paraskevas ◽  
Konstantinos Natsis

Entrapment of the superficial peroneal nerve is an uncommon neuropathy that may occur because of mechanical compression of the nerve, usually at its exit from the crural fascia. The symptoms include sensory alterations over the distribution area of the superficial peroneal nerve. Clinical examination, electrophysiologic findings, and imaging techniques can establish the diagnosis. Variations in the superficial peroneal sensory innervation over the dorsum of the foot may lead to variable results during neurologic examination and variable symptomatology in patients with nerve entrapment or lesions. Knowledge of the nerve's anatomy at the lower leg, foot, and ankle is of essential significance for the neurologist and surgeon intervening in the area.


2020 ◽  
Vol 11 (3) ◽  
pp. 417-421
Author(s):  
Herbert Gbejuade ◽  
Josephine Squire ◽  
Anindya Dixit ◽  
Vipul Kaushik ◽  
Jitendra Mangwani

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