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Cutaneous innervation of the ankle: an anatomical study with clinical implications
Author(s) -
Duscher Dominik,
Wenny Raphael,
Weninger Patrick,
Hirtler Lena
Publication year - 2013
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.27.1_supplement.748.10
Subject(s) - medicine , sural nerve , anatomy , ankle , calcaneus , superficial peroneal nerve , metatarsal bones , cutaneous nerve , lateral malleolus , cadaver , malleolus , deep fascia , saphenous nerve , surgery
Three nerves innervate the skin in the foot and ankle region. The saphenous nerve supplies the skin on the medial side of the foot, the sural nerve the lateral side and the superficial peroneal nerve the middle part. Due to their course in the vicinity of the medial and lateral malleoli, these nerves are at significant risk during orthopedic interventions. The aim of this study is to investigate the distal course of the three cutaneous nerves of the ankle and to determine their exact relationship to easy identifiable bony landmarks. The clarification of the orientation of the nerves around the ankle should be beneficial to the reduction of nerve injuries during surgical approaches in this area. Materials and methods 10 fresh‐frozen and 40 embalmed lower extremities of adults were dissected. The skin and the subcutaneous adipose tissue were removed to expose the underlying neural structures. Appropriate bony landmarks were defined. To locate the exact position of the nerves standardized digital photographs were taken and computer‐assisted measurements were conducted. Results The positions of the superficial peroneal nerve, the sural nerve and the saphenous nerve were measured using reference lines: the intermalleolar line and the line from the fifth metatarsal bone to the highest point of the Lisfranc‐line for the superficial peroneal nerve; the line from the lateral malleolus to the upper border of the calcaneus and the line from the fifth metatarsal bone to the highest point of the Lisfranc line for the sural nerve and the line from the medial malleolus to the head of the talus for the saphenous nerve. Conclusion The determination of the exact orientation of the nerves around the ankle should help minimizing the nerve injury rate during surgical approaches in this area. With the described measuring method using easy to identify bony landmarks the location of the cutaneous nerves of the ankle region could be defined precisely. Grant Funding Source : AAA