Öz
Nervus Fibularis Communis Kaynaklı Nervus Suralis Olgusu
Nervus suralis sırasıyla nervus tibialis’ten kaynaklanan nervus cutaneus surae medialis ve nervus fibularis communis’ten kaynaklanan nervus cutaneus surae lateralis’in birleşmesiyle bacağın arka orta bölümünde oluşur. Ardından malleolus lateralis’e doğru vena saphena parva ile birlikte iner ve ayağın dorsumunun lateralinde nervus cutaneus dorsalis lateralis olarak küçük ayak parmağına doğru uzanır. Nervus varyasyonu bu bölgede çalışan cerrahlar için önemlidir, çünkü tanıda bir biyopsi materyali olarak, tedavide sinir grefti olarak ve sinir iletim çalışmalarında kullanılır. Anabilim dalımız laboratuvarında yapılan rutin diseksiyon sırasında erişkin bir erkek kadavrada sol alt ekstremitede sadece nervus fibularis communis’ten kaynak alan nervus suralis olgusuna rastlanmıştır. Aynı zamanda nervus suralis’in bacağın distal kısmı boyunca vena saphena parva’nın lateralinde ilerlediği de gözlenmiştir. Sağ alt ekstremiteye ait nervus suralis normal seyrinde gözlenmiştir. Bu çalışmada tanımladığımız varyasyonun, radyolojik ve nörolojik çalışmaların yanı sıra bu bölge ile çalışan klinisyenler ve cerrahlar için de faydalı olacağına inanmaktayız.
A Case of The Sural Nerve Originated From The Common Fibular Nerve
The sural nerve is formed by emerging the medial sural cutaneous nerve with lateral sural cutaneous nerve nearby the posterior middle part of the leg, which arises from the tibial nerve and common fibular nerve, respectively. Then, it descends with small saphenous vein towards lateral malleolus and extends towards the little toe as the lateral dorsal cutaneous nerve on the lateral side of the dorsum of the foot. Variation of sural nerve is quite important for surgeons working on this region because it is used as a biopsy material in diagnosis, a nerve graft in treatment and in nerve conduction studies. During the routine cadaver dissections in our laboratory of anatomy department, the sural nerve originated from only common fibular nerve was observed in the left lower extremity of an adult male cadaver. It was also observed that the sural nerve traced the distal part of the leg on the lateral side of the small saphenous vein. The sural nerve of the right lower extremity was observed in its normal course. We believe that the variation we defined in this study will be beneficial for clinicians and surgeons working on this region in addition to radiological and neurological studies.
Anahtar Kelimeler
Kaynakça
- Albay S, Sakallı B, Kastamoni Y, Aydin Candan I, Kocabıyık N. Formation of the sural nerve in foetal cadavers. Folia Morphologica. 2012;71(4): 221-227.
- Amoridis G, Schöls L, Ameridis N, Przuntek H. Motor fibers in the sural nerve of humans. Neurology. 1997; 49 (6): 1725–1728.
- Berry MM, Standring SM, Bannister LH. Nervous system. In: Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE at al (eds.). Gray’s anatomy. 38th ed. Churchill Livingstone. New York, 1995; pp 901–1397.
- Blackmon JA., Atsas S., Clarkson MJ., Fox JN., Daney BT., Dodson SC., Lambert HW. Locating the sural nerve during calcaneal (Achilles) tendon repair with confidence: a cadaveric study with clinical applications. The Journal of Foot & Ankle Surgery. 2013; 52: 42-47.Geng X, Xu J, Ma X, Wang X, Huang J, Zhang C, et al. Anatomy of the sural nerve with an emphasis on the incision for medial displacement calcaneal osteotomy. The Journal of Foot & Ankle Surgery. 2015;54(3):341-344.
- Madhavi C, Isaac B, Antoniswamy B, Holla SJ. Anatomical variations of the cutaneous innervation patterns of the sural nerve on the dorsum of the foot. Clinical Anatomy. 2005; 18 (3): 206–209.
- Nagabhooshana S, Vollala VR, Rodrigues V, Rao M. Anomalous superficial peroneal nerve and variant cutaneous innervation of the sural nerve on the dorsum of the foot: a case report. Cases journal. 2009;2(1):197. doi:10.1186/1757-1626-2-197
- Paraskevas GK., Natsis K., Tzika M., Ioannidis O. Fascial entrapment of the sural nerve and its clinical relevance. Anatomy and Cell Biology. 2014;47(2):144-147.
- Pimentel ML, Fernandes RMP, Babinski MA. Anomalous course of the medial sural cutaneus nerve and its clinical implications. Brazilian Journal of Morphological Sciences. 2005; 22 (3), 179–182.
- Popieluszko P, Mizia E, Henry BM, PA PE, Sanna B, Roy J, et al. The surgical anatomy of the sural nerve: An ultrasound study. Clinical Anatomy. 2018;31(4):450-455.
- Riedl O., Frey M. Anatomy of the sural nerve: Cadaver Study and Literature Review. Plastic and Reconstructive Surgery. 2013; 131: 802-810.
- Tan ACK, Tang ZH, Fadil MFBM. Cadaveric anatomical study of sural nerve: Where is the safe area for endoscopic gastrocnemius recession? The Open Orthopaedics Journal. 2017;11:1094-1098.
Öz
Kaynakça
- Albay S, Sakallı B, Kastamoni Y, Aydin Candan I, Kocabıyık N. Formation of the sural nerve in foetal cadavers. Folia Morphologica. 2012;71(4): 221-227.
- Amoridis G, Schöls L, Ameridis N, Przuntek H. Motor fibers in the sural nerve of humans. Neurology. 1997; 49 (6): 1725–1728.
- Berry MM, Standring SM, Bannister LH. Nervous system. In: Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE at al (eds.). Gray’s anatomy. 38th ed. Churchill Livingstone. New York, 1995; pp 901–1397.
- Blackmon JA., Atsas S., Clarkson MJ., Fox JN., Daney BT., Dodson SC., Lambert HW. Locating the sural nerve during calcaneal (Achilles) tendon repair with confidence: a cadaveric study with clinical applications. The Journal of Foot & Ankle Surgery. 2013; 52: 42-47.Geng X, Xu J, Ma X, Wang X, Huang J, Zhang C, et al. Anatomy of the sural nerve with an emphasis on the incision for medial displacement calcaneal osteotomy. The Journal of Foot & Ankle Surgery. 2015;54(3):341-344.
- Madhavi C, Isaac B, Antoniswamy B, Holla SJ. Anatomical variations of the cutaneous innervation patterns of the sural nerve on the dorsum of the foot. Clinical Anatomy. 2005; 18 (3): 206–209.
- Nagabhooshana S, Vollala VR, Rodrigues V, Rao M. Anomalous superficial peroneal nerve and variant cutaneous innervation of the sural nerve on the dorsum of the foot: a case report. Cases journal. 2009;2(1):197. doi:10.1186/1757-1626-2-197
- Paraskevas GK., Natsis K., Tzika M., Ioannidis O. Fascial entrapment of the sural nerve and its clinical relevance. Anatomy and Cell Biology. 2014;47(2):144-147.
- Pimentel ML, Fernandes RMP, Babinski MA. Anomalous course of the medial sural cutaneus nerve and its clinical implications. Brazilian Journal of Morphological Sciences. 2005; 22 (3), 179–182.
- Popieluszko P, Mizia E, Henry BM, PA PE, Sanna B, Roy J, et al. The surgical anatomy of the sural nerve: An ultrasound study. Clinical Anatomy. 2018;31(4):450-455.
- Riedl O., Frey M. Anatomy of the sural nerve: Cadaver Study and Literature Review. Plastic and Reconstructive Surgery. 2013; 131: 802-810.
- Tan ACK, Tang ZH, Fadil MFBM. Cadaveric anatomical study of sural nerve: Where is the safe area for endoscopic gastrocnemius recession? The Open Orthopaedics Journal. 2017;11:1094-1098.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Ocak 2020 |
| Gönderilme Tarihi | 1 Kasım 2019 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 5 Sayı: 1 |
Kaynak Göster
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