Background Knowledge on the anatomical and morphological characteristics of the superficial peroneal nerve is amenable to further refinement. This cadaveric study aimed to further evaluate anatomical and morphological characteristics of the superficial peroneal nerve. Methods In this study, 10 lower limbs from five fresh cadavers were dissected. The anatomical characteristics of the superficial peroneal nerve were identified. Nerve segments were submitted for histological and morphometric analyses, and nerve thicknesses and number of fascicles were assessed. Results Regarding the superficial peroneal nerve's bifurcation, 80% of the terminal branches were distal to the point of emergence from the fascia. In 90% limbs, two sensory branches were observed immediately after the distal bifurcation of the superficial peroneal nerve. The mean distance from the fibular head to the superficial peroneal nerve's emergence from the fascia was 24.6 cm and mean nerve thickness at this point was 0.3 cm. The mean distance between the lateral malleolus and the main nerve trunk at the ankle was 4.68 cm. The mean distance from the motor branch of the peroneus brevis to the lateral malleolus was 29.3 cm. Morphometric analyses revealed an average five nerve bundles at the broadest nerve diameter (2.6 mm). Conclusion The anatomical and morphometrical characteristics of the superficial peroneal nerve indicate that it may be a safe and useful donor for autologous graft treatment of peripheral nerve injuries. Our morphological study shows a median of five fascicles, and that the thickest diameter of the nerve was 2.6 mm at the emergence from the deep to the superficial compartment.
ObjectiveTo evaluate the clinical results from treating chronic peripheral nerve injuries using the superficial peroneal nerve as a graft donor source.MethodsThis was a study on eleven patients with peripheral nerve injuries in the upper limbs that were treated with grafts from the sensitive branch of the superficial peroneal nerve. The mean time interval between the dates of the injury and surgery was 93 days. The ulnar nerve was injured in eight cases and the median nerve in six. There were three cases of injury to both nerves. In the surgery, a longitudinal incision was made on the anterolateral face of the ankle, thus viewing the superficial peroneal nerve, which was located anteriorly to the extensor digitorum longus muscle. Proximally, the deep fascia between the extensor digitorum longus and the peroneal longus muscles was dissected. Next, the motor branch of the short peroneal muscle (one of the branches of the superficial peroneal nerve) was identified. The proximal limit of the sensitive branch was found at this point.ResultsThe average space between the nerve stumps was 3.8 cm. The average length of the grafts was 16.44 cm. The number of segments used was two to four cables. In evaluating the recovery of sensitivity, 27.2% evolved to S2+, 54.5% to S3 and 18.1% to S3+. Regarding motor recovery, 72.7% presented grade 4 and 27.2% grade 3. There was no motor deficit in the donor area. A sensitive deficit in the lateral dorsal region of the ankle and the dorsal region of the foot was observed. None of the patients presented complaints in relation to walking.ConclusionsUse of the superficial peroneal nerve as a graft source for treating peripheral nerve injuries is safe and provides good clinical results similar to those from other nerve graft sources.
Objectiveto assess the surgical technique using the modified palm open technique for the treatment of severe contractions of Dupuytren's disease.Methodsover a period of four years, 16 patients underwent surgical treatment, and in its entirety belonged to stages III and IV of the classification proposed by Tubiana et al. We performed measurements of the extension deficit of the metacarpophalangeal joints, proximal and distal interphalangeal in preoperative, postoperative (3 months) and late postoperative period (5–8 years). Angles greater than 30° metacarpophalangeal joints and 15° proximal interphalangeal the results were considered surgical recurrence.Resultsthere was obtained an average of 6.3° at the metacarpophalangeal joint, 13.8° in the proximal interphalangeal and distal interphalangeal at 1.9°.Conclusionthe modified open palm technique is an effective method in the surgical treatment of severe contractures in Dupuytren's disease.
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