Abstract

CASTORINA, Damián et al. Ecografía para prevenir lesiones del nervio sural en la reparación del tendón de Aquiles. Estudio cadavérico. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2022, vol.87, n.3, pp.404-412. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2022.87.3.1507.

Introduction: Minimally invasive techniques are preferred to treat acute Achilles tendon ruptures. They represent an option to avoid integumentary complications, and sural nerve injury is one of its main problems. This study aims to verify the usefulness of ultrasound in preventing sural nerve injury during Achilles repair with percutaneous techniques. Materials and Methods: Study in 12 cadaveric pieces. We recreated an injury at the level of the Achilles tendon, 5 cm proximally to its distal insertion. In one of the cadaver limbs, the sural nerve and/or its satellite vein were identified by ultrasonography. We repaired the sural nerve percutaneously with two needles at the proximal level and two needles at the distal level of the lesion and represented the path of the sural nerve. In the contralateral limb, the sural nerve was not identified by ultrasound. We performed the percutaneous repair of the injuries using the Ma & Griffith technique. Results: In the ultrasound group, no sural nerve injuries were identified. In the control group, two sural nerve injuries were observed (p=0.6). In all cases, the identification of the sural nerve by ultrasound was correct. Conclusion: Ultrasound assistance in the percutaneous treatment of Achilles tendon injuries is an effective and reliable method to prevent sural nerve injuries.

Keywords : Acute Achilles tendon rupture; sural nerve injury; ultrasonography; percutaneous techniques; cadaver study.

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