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Archives of Orthopaedic and Trauma Surgery

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01-10-2011 | Trauma Surgery

The risk of nerve injury with minimally invasive plate osteosynthesis of distal fibula fractures: an anatomic study

Authors: Thomas Neubauer, Nima Heidari, Annelie M. Weinberg, Wolfgang Grechenig, Norbert Peter Tesch, Wolfgang Pichler, Michael Wagner

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2011

Abstract

Aim

The aim of our study was to identify the structures which may be at risk of injury when using a minimally invasive technique for the osteosynthesis of the lateral malleolus and the influence of the size of the implant on the frequency of injury to these structures.

Method

Forty plates were percutaneously inserted in 20 cadaveric legs. The region around the plate was then dissected to examine the relation of nerves and soft tissues to the plate.

Results

The superficial peroneal nerve was in direct contact with the plate in 11 of the 20 cases (55%) of the 10 hole plates. We encountered only one case of the superficial peroneal nerve skirting the proximal edge of a 6 hole plate (p = 0.0164).

Conclusion

Consequently we recommend meticulous attention is paid to the dissection of soft tissues in both the proximal and distal incisions. The length of the plate may be checked with intraoperative imaging prior to its insertion, and the site of both proximal and distal incisions may be marked on the skin. After careful dissection down to the bone, preserving nerves and tendons, the periosteal elevator should be introduced both from the proximal as well as the distal incisions to prepare the extra-periosteal tunnel for the insertion of the plate, in order to avoid the entanglement of the superficial peroneal nerve with the metal work, particularly in plates of longer than six holes.

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Title: The risk of nerve injury with minimally invasive plate osteosynthesis of distal fibula fractures: an anatomic study
Authors: Thomas Neubauer
Nima Heidari
Annelie M. Weinberg
Wolfgang Grechenig
Norbert Peter Tesch
Wolfgang Pichler
Michael Wagner
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2011
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-011-1318-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The risk of nerve injury with minimally invasive plate osteosynthesis of distal fibula fractures: an anatomic study

Abstract

Aim

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Aim

Method

Results

Conclusion

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