An anatomical and cadaveric study examining the risk of sural nerve injury in percutaneous Achilles tendon repair using the Achillon device

• Published in: Foot and ankle surgery Vol. 20; no. 2; pp. 90 - 93
• Main Authors: Porter, Ken J., BM, BSc, MRCS, Robati, Shibby, MBBS, MSc, Karia, Priyesh, BSc, Portet, Mark, BMBS, Szarko, Matthew, PhD, Amin, Amit, MB, ChB, FRCS(Orth)
• Format: Journal Article
• Language: English
• Published: France Elsevier Ltd 01.06.2014
• Subjects: Achilles tendon; Achilles Tendon - injuries; Achilles Tendon - surgery; Achillon; Cadaver; Humans; Orthopedics; Percutaneous repair; Reconstructive Surgical Procedures - adverse effects; Reconstructive Surgical Procedures - instrumentation; Risk Factors; Rupture; Sural nerve; Sural Nerve - anatomy & histology; Sural Nerve - injuries; Tendon Injuries - surgery; Achilles tendon; Percutaneous repair; Achillon; Sural nerve; Rupture
• ISSN: 1268-7731; 1460-9584
• DOI: 10.1016/j.fas.2013.11.005

Abstract Background Percutaneous Achilles tendon repairs are gaining in popularity. This study aims to quantify the risk of sural nerve injury when using the Achillon device. Methods The Achillon device was instrumented into 15 cadaveric specimens and through dissection the rate of sural nerve puncture and the position of the sural nerve in relation to the Achilles tendon was documented. Results The sural nerve was found lateral to the Achilles tendon insertion point over a range of 14.3 mm and crossed the lateral border of the Achilles tendon over a range of 57.7 mm. The sural nerve was punctured a total of 6 times and in 4 out of 15 cadaveric specimens (27%). Four out of the 6 punctures occurred when the Achillon device was instrumented distally. Conclusions The sural nerve displays a highly variable anatomical course and there is a risk of puncture during percutaneous Achilles tendon repair using the Achillon device.