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Easily identifiable bony landmarks as an aid in targeted regional ankle blockade.
Clin Anat. 2005 Oct; 18(7):518-26.CA

Abstract

Regional anesthesia around the ankle joint is well suited to a large number of surgical procedures of the foot. Previous studies have alluded to the variable nerve distribution of the foot, which may result in incomplete blocks. The aim of the study was to determine the position of the nerves in relation to the ankle joint to easily identifiable bony and prominent soft tissue landmarks to aid more accurate targeting of these nerves. A number of 94 ankles (47 left; 47 right) were dissected to expose the tibial, sural, deep fibular (peroneal), superficial fibular (peroneal), and saphenous nerves. The distance of the nerves relative to easy to find bony landmarks was measured. A distance (alpha) was measured from the middle of the tibial nerve to the most medial aspect of the medial malleolus. Measurement beta was considered from the inferior tip of the lateral malleolus to the anterior border of the sural nerve on a horizontal plane. Measurement delta was taken from the medial border of the deep fibular (peroneal) nerve to the most anterior aspect of the medial malleolus. epsilon was measured from the middle of the superficial fibular (peroneal) nerve to the most anterior aspect of the medial malleolus on a horizontal plane. The saphenous nerve was measured (gamma) from its medial border to the most anterior aspect of the medial malleolus on a horizontal plane. Factors such as sex, length, and ankle side were also analyzed concerning their influence on the position of the nerves. This study suggests that a greater degree of certainty may possibly be attained when palpable and easy to find bony landmarks are used to determine the position of the nerves around the ankle and ensure a simple to perform, predictable, and selectively targeted block.

Authors+Show Affiliations

Department of Anatomy, Section of Clinical Anatomy, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16121391

Citation

Schabort, D, et al. "Easily Identifiable Bony Landmarks as an Aid in Targeted Regional Ankle Blockade." Clinical Anatomy (New York, N.Y.), vol. 18, no. 7, 2005, pp. 518-26.
Schabort D, Boon JM, Becker PJ, et al. Easily identifiable bony landmarks as an aid in targeted regional ankle blockade. Clin Anat. 2005;18(7):518-26.
Schabort, D., Boon, J. M., Becker, P. J., & Meiring, J. H. (2005). Easily identifiable bony landmarks as an aid in targeted regional ankle blockade. Clinical Anatomy (New York, N.Y.), 18(7), 518-26.
Schabort D, et al. Easily Identifiable Bony Landmarks as an Aid in Targeted Regional Ankle Blockade. Clin Anat. 2005;18(7):518-26. PubMed PMID: 16121391.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Easily identifiable bony landmarks as an aid in targeted regional ankle blockade. AU - Schabort,D, AU - Boon,J M, AU - Becker,P J, AU - Meiring,J H, PY - 2005/8/27/pubmed PY - 2006/1/4/medline PY - 2005/8/27/entrez SP - 518 EP - 26 JF - Clinical anatomy (New York, N.Y.) JO - Clin Anat VL - 18 IS - 7 N2 - Regional anesthesia around the ankle joint is well suited to a large number of surgical procedures of the foot. Previous studies have alluded to the variable nerve distribution of the foot, which may result in incomplete blocks. The aim of the study was to determine the position of the nerves in relation to the ankle joint to easily identifiable bony and prominent soft tissue landmarks to aid more accurate targeting of these nerves. A number of 94 ankles (47 left; 47 right) were dissected to expose the tibial, sural, deep fibular (peroneal), superficial fibular (peroneal), and saphenous nerves. The distance of the nerves relative to easy to find bony landmarks was measured. A distance (alpha) was measured from the middle of the tibial nerve to the most medial aspect of the medial malleolus. Measurement beta was considered from the inferior tip of the lateral malleolus to the anterior border of the sural nerve on a horizontal plane. Measurement delta was taken from the medial border of the deep fibular (peroneal) nerve to the most anterior aspect of the medial malleolus. epsilon was measured from the middle of the superficial fibular (peroneal) nerve to the most anterior aspect of the medial malleolus on a horizontal plane. The saphenous nerve was measured (gamma) from its medial border to the most anterior aspect of the medial malleolus on a horizontal plane. Factors such as sex, length, and ankle side were also analyzed concerning their influence on the position of the nerves. This study suggests that a greater degree of certainty may possibly be attained when palpable and easy to find bony landmarks are used to determine the position of the nerves around the ankle and ensure a simple to perform, predictable, and selectively targeted block. SN - 0897-3806 UR - https://www.unboundmedicine.com/medline/citation/16121391/Easily_identifiable_bony_landmarks_as_an_aid_in_targeted_regional_ankle_blockade_ L2 - https://doi.org/10.1002/ca.20191 DB - PRIME DP - Unbound Medicine ER -