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Surgery and Behavioral Testing in the Tibial Neuroma Transposition Model in Rats

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Published on: January 6, 2023

Posterior tibial nerve lesions in ankle arthroscopy.

Ramon Cugat¹, Oscar Ares, Xavier Cuscó

¹Artroscopia G.C. Clínica del Pilar, C / Balmes 271, 08006, Barcelona, Catalonia, Spain.

Archives of Orthopaedic and Trauma Surgery

|July 10, 2007

Summary

Ankle arthroscopy, a minimally invasive procedure, carries risks of neurological complications due to its superficial anatomy. This paper details a rare case of posterior tibial nerve damage during ankle arthroscopy, highlighting portal placement risks.

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Area of Science:

Orthopaedic Surgery
Minimally Invasive Procedures
Neurovascular Anatomy

Background:

Ankle arthroscopy is a common minimally invasive surgical technique for diagnosing and treating ankle pathologies.
The superficial location of the ankle joint and numerous periarticular neurovascular structures increase complication risks compared to other joints.
Neurological complications, particularly neurovascular injuries, are recognized risks associated with ankle arthroscopy.

Observation:

This study presents the second reported case of intra-articular posterior tibial nerve damage following ankle arthroscopy in the English-language literature.
The injury was a direct result of distractor pin or portal placement, specifically related to the posteromedial portal.
Variability in the course of surgical portals and their proximity to neurovascular structures contributes to the risk.

Findings:

Posterior tibial nerve injury is a rare but significant complication of ankle arthroscopy.
The standard posteromedial portal poses a risk due to its proximity to the posterior neurovascular bundle.
Careful attention to portal placement and awareness of anatomical variations are crucial to prevent such injuries.

Implications:

Highlights the importance of meticulous surgical technique and anatomical knowledge during ankle arthroscopy.
Suggests a need for enhanced awareness and potentially modified techniques to minimize neurovascular injury risks.
Contributes to the literature on rare complications, aiding in future prevention strategies and patient counseling.