scholarly journals A Part of the Medial Branch of the Deep Peroneal Nerve Distributes the Dorsal Pedis Artery and Its Distribution Area is Close to the Acupuncture Point LR3 (Taichong)

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Kanae Umemoto ◽  
Munekazu Naito ◽  
Naoyuki Hatayama ◽  
Shuichi Hirai ◽  
Kou Sakabe
Keyword(s):  
Peroneal Nerve ◽  
Acupuncture Point ◽  
Specific Area ◽  
Distribution Area ◽  
Medial Branch ◽  
Deep Peroneal Nerve ◽  
Metatarsal Bones ◽  
Second Metatarsal ◽  
The Mean ◽  
Arterial Constriction

Cutaneous nerves have vascular branches (VBs) that reach the arteries and are thought to be involved in arterial constriction. We aimed to examine the anatomical and histological relationship between the VBs of a cutaneous nerve in the foot and the acupuncture point LR3 (Taichong), which is a depression between the base of the first and second metatarsal bones on the dorsum of the foot and is a source point of the foot. We examined 40 cadaver feet to assess the distribution areas of the VBs of the medial branch of the deep peroneal nerve (MBDPN). MBDPNs were distally followed to identify the point where the VBs reached the arteries. The distance between the point and LR3 was measured. Sympathetic fibers in the VBs were histologically observed using tyrosine hydroxylase (TH) immunostaining. The VBs of the MBDPNs reaching the dorsal pedis arteries were observed in all specimens (100%). The mean distance between LR3 and the point where the VBs of the MBDPN reached the arteries was 3.2 ± 2.6 mm. Among the VBs, 70% were distributed proximal to LR3. Moreover, TH-positive fibers were present in the VBs. These findings revealed that a part of the MBDPN distributed the dorsal pedis artery and contained sympathetic fibers. We also found that the distribution area of the VBs was close to LR3. Our study provides anatomical evidence that LR3 is a specific area and its stimulation would be useful for treating peripheral circulatory failure.

scholarly journals Anterocentral Portal in Ankle Arthroscopy

2020 ◽  
Vol 41 (9) ◽  
pp. 1133-1142
Author(s):  
Christoph Stotter ◽  
Thomas Klestil ◽  
Andreas Chemelli ◽  
Vahid Naderi ◽  
Stefan Nehrer ◽  
...  
Keyword(s):  
Peroneal Nerve ◽  
Ankle Arthroscopy ◽  
Anterior Tibial Artery ◽  
Medial Branch ◽  
Superficial Peroneal Nerve ◽  
Deep Peroneal Nerve ◽  
Tibial Artery ◽  
Anterior Tibial ◽  
Anterolateral Portal

Background: The anterocentral portal is not a standard portal in anterior ankle arthroscopy due to its proximity to the anterior neurovascular bundle. However, it provides certain advantages, including a wide field of vision, and portal changes become redundant. The purpose of this study was to evaluate the neurovascular complications after anterior ankle arthroscopy using the anterocentral portal. Methods: We retrospectively identified patients who had undergone anterior ankle arthroscopy with an anterocentral portal at our institution from 2013 to 2018. Medical record data were reviewed and patients were invited for clinical follow-up, where a clinical examination, quantitative sensory testing for the deep peroneal nerve, and ultrasonography of the structures at risk were performed. A total of 101 patients (105 arthroscopies) were identified and evaluated at a mean follow-up of 31.5 ± 17.7 months. Results: Leading indications to surgery were heterogeneous and included anterior impingement (48.6%), osteochondral lesions of the talus (24.8%), chronic ankle instability (14.3%), and fractures (8.6%). The overall complication rate was 7.6%, and no major complications were observed. In 1.9% (2/105) of the cases, the complications were associated with the anterocentral portal and included injury to the medial branch of the superficial nerve (1/105) and to the deep peroneal nerve (1/105). Injury to the deep peroneal nerve was associated with a loss of detection and nociception. There were no injuries to the anterior tibial artery. In 41.9% (44/105) of the cases, only 1 working portal was used in addition to the anterocentral portal, and in 19% (20/105) the anterolateral portal could be avoided. Ultrasonography confirmed the integrity of the deep peroneal nerve, the medial branch of the superficial peroneal nerve, and the anterior tibial artery in all patients. Patients with nerve injuries associated with the anterocentral portal showed no signs of neuroma or pseudoaneurysm. Conclusion: Using a standardized technique, the anterocentral portal in ankle arthroscopy is safe with a low number of neurovascular injuries and can be recommended as a standard portal. The anterolateral portal remains associated with a high number of injuries to the superficial peroneal nerve. Level of Evidence: Level III, retrospective cohort study.

scholarly journals Treatment of nocturnal leg cramps by blockade of the medial branch of the deep peroneal nerve after lumbar spine surgery

2015 ◽  
Vol 5 (9) ◽  
Author(s):  
Takayuki Imura ◽  
Gen Inoue ◽  
Toshiyuki Nakazawa ◽  
Masayuki Miyagi ◽  
Wataru Saito ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Peroneal Nerve ◽  
Lumbar Spine Surgery ◽  
Medial Branch ◽  
Deep Peroneal Nerve

scholarly journals Persistent Symptoms of Ganglion Cysts in the Dorsal Foot

2017 ◽  
Vol 11 (1) ◽  
pp. 1308-1313
Author(s):  
Akio Sakamoto ◽  
Takeshi Okamoto ◽  
Shuichi Matsuda
Keyword(s):  
Peroneal Nerve ◽  
Cystic Lesion ◽  
Subcutaneous Tissue ◽  
Lesion Size ◽  
Medial Branch ◽  
Deep Peroneal Nerve ◽  
Persistent Symptoms ◽  
Dorsalis Pedis Artery ◽  
Experienced Pain ◽  
Ganglion Cysts

Background: A ganglion is a common benign cystic lesion, containing gelatinous material. Ganglia are most commonly asymptomatic, except for a lump, but symptoms depend on the location. A dorsal foot ganglion is typically painful. On the dorsal foot, the dorsalis pedis artery and the medial branch of the deep peroneal nerve are located under the fascia. Objective: Five female patients of average age 45.8 ± 20 years (range, 12 to 60 years) with a painful ganglion in the dorsal foot were analyzed. Results: Average lesion size was 2.94 ± 1.1 cm (range, 1.5 to 4.0 cm) and patients had experienced pain for a median of 2-3 years (range, 6 months to 3 years). Four patients had a single cystic lesion and 1 patient had developed multiple cystic lesions over the time that were associated with hypoesthesia. In 3 cases, symptomatic lesions were located deep beneath the fascia and were resected. In 2 cases, the depth of the non-resected lesions was shallow. Conclusion: The cause of a painful dorsal foot ganglion can be attributed to its location in the thin subcutaneous tissue over the foot bone, in addition to its proximity to a nearby artery and nerve. Mild symptoms caused by a dorsal foot ganglion seem to be persistent, and the deeper the location, the more likely is the need for resection. To avoid nerve injury, anatomical knowledge is prerequisite to any puncturing procedure or operation performed.

The response to radiofrequency neurotomy of medial branches including a bipolar system for thoracic facet joints

2018 ◽  
Vol 18 (4) ◽  
pp. 747-753
Author(s):  
Olav Rohof ◽  
Chee Kean Chen
Keyword(s):  
Joint Pain ◽  
Rating Scale ◽  
Facet Joint ◽  
Controlled Trial ◽  
Case Series ◽  
Interventional Treatment ◽  
Medial Branch ◽  
Pain Disability Index ◽  
The Mean ◽  
Facet Joint Pain

AbstractBackground and aimsThe evidence for interventional treatment of thoracic facet joint pain remains limited. This is partly due to inconsistency of the path of thoracic medial branches and a lower incidence of thoracic facet pain among spine pain patients. The purpose of this study is to evaluate the efficacy of bipolar radiofrequency (RF) neurotomy of medial branches for treating chronic thoracic facet joint pain.MethodsThis is a retrospective record review of all patients diagnosed to have thoracic facet pain with diagnostic block and subsequently treated with bipolar RF neurotomy of medial branch between January 2012 and December 2015. The outcome measures were mean changes in Numeral Rating Scale (NRS) and Pain Disability Index (PDI).ResultsThere were 71 patients with complete data available for analysis. The mean age of the patients was 57.9±11.2 years. The mean duration of pain was 23±10.5 months. The majority of patients (82%) had pain reduction of more than 50% at 12 months after bipolar RF neurotomy. The NRS decreased significantly from baseline of 7.75±1.25 to 2.86±1.53 at 3 months and 2.82±1.29 at 12 months post-procedure (p<0.001.p<0.001, respectively). The PDI improved significantly from 40.92±12.22 to 24.15±9.79,p<0.05). There were no serious adverse effects or complications of the procedure reported in this study.ConclusionsBipolar RF neurotomy of thoracic medial branch is associated with a significant reduction in thoracic facet joint pain. The promising findings from this case series merit further assessment with prospective, randomized controlled trial which will produce a more reliable and accurate finding for its clinical applications.

F-wave studies on the deep peroneal nerve

1977 ◽  
Vol 31 (3) ◽  
pp. 319-329 ◽  
Author(s):  
C.P. Panayiotopoulos ◽  
S. Scarpalezos ◽  
P.E. Nastas
Keyword(s):  
Peroneal Nerve ◽  
Deep Peroneal Nerve ◽  
F Wave

scholarly journals Treatment of Hallux Valgus Deformity Using a Suture Button Device: A Preliminary Report

2018 ◽  
Vol 3 (4) ◽  
pp. 247301141880695
Author(s):  
Tyler A. Gonzalez ◽  
Jeremy T. Smith ◽  
Eric M. Bluman ◽  
Lauren V. Ready ◽  
William Ciurylo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Hallux Valgus ◽  
Normal Position ◽  
Suture Button ◽  
Soft Tissue Procedure ◽  
Sf 36 ◽  
Second Metatarsal ◽  
Average Change ◽  
The Mean

Background: Hallux valgus (HV) is commonly treated with proximal or distal first metatarsal osteotomy. Despite good correction, these procedures have inherent risks such as malunion, nonunion, metatarsal shortening, loss of fixation, and avascular necrosis. Suture button fixation has been used for HV treatment. It avoids the risks of corrective osteotomies while maintaining reduction of the intermetatarsal angle (IMA). The goal of this study was to assess the radiographic and functional outcomes of patients undergoing HV correction with a distal soft tissue procedure and proximal suture button fixation. Methods: The authors retrospectively reviewed the charts and radiographs of 22 patients who had undergone HV correction using a distal soft tissue correction and proximal fixation with a miniature suture button device (Mini TightRope; Arthrex, Inc, Naples, FL). Mean follow-up was 27.7 months. The IMA, hallux valgus angle (HVA), and sesamoid station were measured on radiographs obtained preoperatively as well as in the immediate postoperative period and at final follow-up. Preoperative and postoperative Short Form-36 (SF-36) and Foot and Ankle Ability Measure (FAAM) scores were collected. Postoperative complications, and any additional operative procedures performed were also recorded. Results: The mean preoperative IMA and HVA were 16.9 and 32.6 degrees, respectively. The mean immediate postoperative IMA was 5.2 degrees ( P < .0001) and the mean HVA was 9.8 degrees ( P < .0001). At final follow-up, the mean IMA was 8.2 degrees ( P < .0001) and the mean HVA was 16.7 degrees ( P < .0001). The average change in HVA from preoperative to final follow-up was 16.0 degrees and the average change in IMA from preoperative to final follow-up was 8.6 degrees ( P < .0001). Sesamoid station assessment at the 2-week follow-up showed that 22 patients (100%) were in the normal position group; at final follow-up, 17 patients (77%) had normal position and 5 patients (23%) had displaced position. Although there were no clinically symptomatic recurrences, asymptomatic radiographic recurrence was noted in 5 patients (23%) who had a final HVA >20 degrees. All components of the FAAM and the SF-36 showed improvement from preoperative to final follow-up, although these changes were not statistically significant. Three patients experienced complications, including an intraoperative second metatarsal fracture, a postoperative second metatarsal stress fracture, and a postoperative deep vein thrombosis. Conclusion: The use of a distal soft tissue procedure in conjunction with proximal suture button fixation is a safe and effective procedure for treating symptomatic HV deformity. Our results show that this technique can correct the IMA, HVA, and sesamoid station without the need for osteotomy. Level of evidence: Level IV.

scholarly journals HDPE/SILICA COMPOSITES- PART I: PREPARATION AND CHARACTERIZATION OF METHYLSILANE AND OCTYLSILANE-MODIFIED SILICAS

2019 ◽  
Vol 16 (32) ◽  
pp. 263-278
Author(s):  
Vanessa Machado Babinski RAMOS ◽  
Maurício Gammertt RÖHNELT ◽  
Rodrigo BRAMBILLA
Keyword(s):  
Silica Gel ◽  
Morphological Characteristics ◽  
Specific Area ◽  
Sem Images ◽  
Adsorption Sites ◽  
Pyrogenic Silica ◽  
The Mean ◽  
Complementary Techniques ◽  
Adsorption Desorption

This paper reports the main results concerning the synthesis and characterization of methylsilane and octylsilane-modified silicas. The modification of the silicas with these groups aims to make the silica surface hydrophobic and thus compatible with high-density polyethylene (HDPE) in HDPE/silica composites. In the present work, two types of silica were organofunctionalized: a pyrogenic silica and a silica gel. The silicas were characterized by a series of complementary techniques with the objective of investigating the nature of the surface species and their textural and morphological characteristics. The SEM images showed that the modification of the silicas with organosilanes has been not resulted in changes on the morphology and on the size of silica particles. In relation to the texture properties, determined by N2 adsorption-desorption porosimetry, the silica modification resulted in a decrease of the specific area (SBET) and the mean pore volume, a behavior attributed to the partial coverage of the adsorption sites by the organosilane molecules. The TGA analysis showed that both the methylsilane groups and the octylsilane groups on the surface of silica and silica gel are thermally stable up to 200 ° C, which enables the organofunctionalized silicas in terms of thermal stability, for the process of preparing the composites by extrusion. The results of applying these organofunctionalized silicas in the development of HDPE/silica composites will be presented in a subsequent article, part II of this research.

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