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Updated: Jul 21, 2025
An Anatomical Study of Nerves at Risk During Minimally Invasive Hallux Valgus Surgery
Published on: February 17, 2018
Anatomical principles of ankle denervation - An update
Richard-Tobias Moeller1, Martin Mentzel1, Michael Gabel2
1Department for Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany.
Background:
Denervation is a surgical option in ankle arthrosis when conservative therapy has failed. Sectioning all joint branches is essential for its success. The locations of the articular branches of the saphenous (Sa), tibial (Ti), sural (Su), superficial (Ps) and deep peroneal (Pp) nerves are specified.
Methods:
In 16 cryopreserved specimens, the courses of the nerves were prepared. Their articular branches were identified, and their respective locations documented by using a new reference system.
Results:
The articular branches to the ankle ranged from 5 to 30 cm measured from the foot sole. The Sa should be transected at 22.5 cm, the Su at 20 cm, and the Pp at 15 cm. The Ti should be skeletonized up to 25 cm. Epifascial dissection of the Ps is to be performed below 15 cm.
Conclusion:
The study specifies the joint branches of the ankle in an intraoperatively reproducible reference system and thus minimizes the required skin incisions.
