1.The comprehensive review of the neurovascular supply of the ankle joint: clinical implications
Chirapat INCHAI ; Tanawat VASEENON ; Pasuk MAHAKKANUKRAUH
Anatomy & Cell Biology 2020;53(2):126-131
The rupture of ligament in the lateral part of ankle joint is a common injury and can lead to chronic ankle instability and lead to ankle osteoarthritis. Ankle arthroscopy is considered as a standard option to treat various ankle problems due to the need for only minimal incisions and fewer complications when compared to open surgery. However, there are complications associated with arthroscopic surgery e.g. damage to the anatomical structures around the portal placement areas. The present review provides anatomical knowledge of the superficial and deep neurovascular structures in the ankle region. These structures are important when ankle surgery is performed in order to avoid any intraoperative injury and prevent any complication following surgery.
2.The distribution pattern of the dorsal cutaneous nerves of the foot and its clinical implications
Chirapat INCHAI ; Tanawat VASEENON ; Yasuhito TANAKA ; Pasuk MAHAKKANUKRAUH
Anatomy & Cell Biology 2020;53(2):137-142
Iatrogenic injury to subcutaneous nerves on the dorsum of the foot is an established risk factor during the surgical procedures resulting in postoperative pain, sensation loss and painful neuroma. Previous studies have reported on the distribution pattern of the superficial peroneal, deep peroneal and sural nerves (SNs) and their branches with various classifications about specific populations. The purpose of the present study was to evaluate the distribution pattern and classification of the nerves on the dorsum of the foot and analyze the location of these nerves into five zones with clinical implications. Fifty-four lower limbs of fresh frozen cadavers were used in the present study. The anatomical patterns of the superficial peroneal, deep peroneal, SN and their branches were classified into eight, two and five patterns respectively. Type VI pattern, a classic distribution pattern of the superficial peroneal nerve was the most frequent type with a prevalence of 13 limbs (25.00%). In Zone 5, where the arthroscopic portal placements for the first metatarsophalangeal joint arthrodesis, 29 limbs (55.77%) showed three nerve branches located in this zone. The results of the present study provide anatomical knowledge that may help the surgeon to choose the appropriate treatment for their patients and reducing the rate of complications in surgery.