Superficial Peroneal Nerve Injury Risk During a Semiblind Fasciotomy for Anterior Chronic Exertional Compartment Syndrome of the Leg: An Anatomical and Clinical Study
| Autor: | Henricus P.H. Hundscheid, Johan A. de Bruijn, Marc R. Scheltinga, Adwin R. Hoogeveen, Aniek P. M. van Zantvoort, Joep A.W. Teijink |
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| Přispěvatelé: | Epidemiologie, RS: CAPHRI - R5 - Optimising Patient Care, Surgery |
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty superficial peroneal nerve medicine.medical_treatment anterior compartment TERM DIAGNOSIS ENDOSCOPICALLY ASSISTED FASCIOTOMY Fasciotomy Clinical study FASCIAL HERNIAS 03 medical and health sciences 0302 clinical medicine Cadaver MANAGEMENT Humans Medicine Injury risk Orthopedics and Sports Medicine Intraoperative Complications Surgical treatment Chronic exertional compartment syndrome Aged Aged 80 and over RELEASE 030222 orthopedics business.industry Superficial peroneal nerve Peroneal Nerve CECS 030229 sport sciences medicine.disease Surgery SURGICAL-TREATMENT Anterior Compartment Syndrome Female business fasciotomy |
| Zdroj: | Foot & Ankle International, 40(3), 343-351. SAGE Publications Inc. |
| ISSN: | 1944-7876 1071-1007 |
| DOI: | 10.1177/1071100718811632 |
| Popis: | Background: Up to 8% of patients who underwent a fasciotomy for leg anterior chronic exertional compartment syndrome (ant-CECS) report sensory deficits suggestive of iatrogenic superficial peroneal nerve (SPN) injury. In the current study we aimed to thoroughly assess the risk of SPN injury during a semiblind fasciotomy of the anterior compartment using 2 separate approaches. Methods: A modified semiblind fasciotomy of the anterior compartment was performed via a longitudinal 2-cm skin incision 2 cm lateral of the anterior tibial crest halfway along the line fibular head-lateral malleolus both in cadaver legs and in patients with ant-CECS. In the cadaver legs, the skin was removed after the procedure and possible SPN injuries and spatial relationships between the SPN and the opened fascia were studied. Between January 2013 and December 2016, 64 ant-CECS patients who underwent a fasciotomy of the anterior compartment were prospectively followed. Iatrogenic SPN injuries were assessed using questionnaires and physical examinations. Results: Macroscopic SPN nerve injury was not observed in any of the 9 cadaver legs. In 8 specimens, the SPN was located at least 5 mm posterolateral to the opened fascia. In 1 specimen, an undamaged SPN branch crossed the operative field in a ventral plane. De novo sensory deficits suggestive for iatrogenic SPN injury were not observed in any of the 64 patients (120 legs; 36 females; median age, 22 years) who underwent a fasciotomy of the anterior compartment. Conclusion: The proposed semiblind fasciotomy for treatment of ant-CECS was not associated with SPN injury in either the cadaveric study or our clinical series. Level of Evidence: Level IV, case series. |
| Databáze: | OpenAIRE |
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