Saphenous nerve innervation of the medial ankle

Steven R Clendenen, Joseph L Whalen, Steven R Clendenen, Joseph L Whalen

Abstract

Background: The distal saphenous nerve is commonly known to provide cutaneous innervation of the medial side of the ankle and distally to the base of the great toe. We hypothesize that the saphenous nerve innervates the periosteum of the medial malleolus and joint capsule.

Methods: Five fresh limbs were dissected and the saphenous nerve was traced distally with magnification. The medial malleolus, talus, and soft tissue were fixed in formaldehyde, decalcified, and embedded in paraffin and sectioned. Histologic slides were then prepared using S100 antibody nerve stains.

Results: Histologic slides were examined and myelinated nerves could be observed within the medial capsule and periosteum in all the specimens.

Conclusion: We have demonstrated that the saphenous nerve innervates the periosteum of the medial malleolus and joint capsule.

Keywords: innervation; medial ankle; saphenous nerve.

Figures

Figure 1
Figure 1
Gross dissection of medial ankle.
Figure 2
Figure 2
Paraffn-embedded specimen of medial ankle.
Figure 3
Figure 3
Photograph of histologic slide of saphenous nerve in the joint capsule.
Figure 4
Figure 4
Photograph of histologic slide of saphenous nerve in the periosteum, 40×.

References

    1. Hadzic A. Textbook of Regional Anesthesia and Acute Pain Management. New York, NY: McGraw-Hill Professional; 2006.
    1. Craig EJ, Clinchot DM. Femoral neuropathy. In: Frontera WR, Silver JK, Rizzo TD, editors. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, PA: Saunders Elsevier; 2008.
    1. Wedel DJ, Horlocker TT. Nerve blocks. In: Miller RD, editor. Miller’s Anesthesia. 7th ed. Philadelphia, PA: Churchill Livingstone Elsevier; p. 2010.
    1. Canale ST, Beaty JH. Campbell’s Operative Orthopaedics. Philadelphia, PA: Mosby Elsevier; 2008.
    1. Marx J, Hockberger R, Walls R. Rosen’s Emergency Medicine – Concepts and Clinical Practice. Philadelphia, PA: Mosby Elsevier; 2010.
    1. Mentzel M, Fleischmann W, Bauer G, Kinzl L. Ankle joint denervation. Part 1. Anatomy: the sensory innervation of the ankle joint. Foot Ankle Surg. 1999;5:15–20.
    1. Mercer D, Morrell NT, Fitzpatrick J, et al. The course of the distal saphenous nerve: a cadaveric investigation and clinical implications. Iowa Orthop J. 2011;31:231–235.
    1. Kosinski C. The course, mutual relations and distribution of the cutaneous nerves of the metazonal region of leg and foot. J Anat. 1926;60:274–297.
    1. Huelke DF. The origin of the peroneal communicating nerve in adult man. Anat Rec. 1958;132:81–92.
    1. Gonzalez-Martinez T, Perez-Pinera P, Diaz-Esnal B, Vega JA. S-100 proteins in the human peripheral nervous system. Microsc Res Tech. 2003;60:633–638.
    1. Sarrafian SK, Kelikian AS. Sarrafian’s anatomy of the foot and ankle. In: Kelikian AS, editor. Sarrafian’s Anatomy of the Foot and Ankle. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2011.
    1. Blumenthal S, Borgeat A, Neudorfer C, Bertolini R, Espinosa N, Aguirre J. Additional femoral catheter in combination with popliteal catheter for analgesia after major ankle surgery. Br J Anaesth. 2011;106:387–393.
    1. Kapoor R, Adhikary SD, Siefring C, McQuillan PM. The saphenous nerve and its relationship to the nerve to the vastus medialis in and around the adductor canal: an anatomical study. Acta Anaesthesiol Scand. 2012;56:365–367.

Source: PubMed

3
Abonner