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Iatrogenic posterior tibial nerve division during ankle arthroscopy
1C.V. Starr Hand Surgery Center, St. Luke's/Roosevelt Hospital, New York, New York 10019, USA.
Summary
Ankle arthroscopy can cause nerve damage. This case report details the first instance of a complete posterior tibial nerve division during arthroscopic loose body removal, highlighting risks of aggressive intra-articular manipulation.
Area of Science:
- Orthopedic Surgery
- Neuroscience
- Anatomy
Background:
- Ankle arthroscopy is a common procedure for diagnosing and treating ankle disorders.
- Neurological complications are potential risks due to the ankle's complex anatomy.
- Previous reports linked nerve injuries to distractors or portal placement.
Observation:
- This study presents a unique case of posterior tibial nerve division.
- The injury occurred during ankle arthroscopy for loose body removal.
- Aggressive intra-articular manipulation is suspected as the cause.
Findings:
- Complete division of the posterior tibial nerve was identified.
- This is the first reported case of such a severe injury from ankle arthroscopy.
- The deep peroneal nerve is also at risk from anterior ankle procedures.
Implications:
- Highlights the risk of severe neurological injury during ankle arthroscopy.
- Emphasizes the need for careful surgical technique and awareness of nerve pathways.
- Suggests potential modifications to arthroscopic procedures to minimize nerve damage risk.