LAUSR

Address for Correspondence: Dr. M Shilpa, Assistant professor, Department of Anatomy, Adichunchanagiri Institute of Medical Sciences, Mandya. Karnataka, India. Mobile No: 7411543525 E-Mail: [email protected] Background: The sural nerve is a major cutaneous nerve of the lower limb that courses through the posterolateral leg to supply the lateral margin of the hindfoot and midfoot and the ankle joint. The sural nerve accompanies the small saphenous vein as it descends in the posterior leg, traveling inferolateral as it crosses the lateral border of the calcaneal (Achilles) tendon. It then passes posterior to the lateral malleolus and terminates as the lateral dorsal cutaneous nerve supplying the lateral aspect of the foot. The precise knowledge of Sural Nerve crossing the lateral border of Achilles Tendon at particular distance proximal to Calcaneal tuberosity will help the surgeon to avoid Sural nerve injury at that point in a given leg length. Aim: The objective of the study are: (1)To measure horizontal distance of the Sural nerve in relation to the lateral border of Achilles tendon.(2)To measure length of the lower limb from the base of the heel to flexor aspect of poppliteal fossa. Materials and Methods: The study was done on 64 lower limbs human cadaver specimens which were collected from dissection room from Department of Anatomy,Mysore Medical College, over a period of 2 years.The specimens obtained were fixed in 10% formalin and were finely dissected . Results: In 64 dissected limbs the present study investigated the point at which the sural nerve crosses the lateral border of the Achilles tendon, as measured from the superior aspect of the calcaneal tuberosity. For example, in 42 cms leg length the average point of intersection was at 4.28 cms above the calcaneal tuberosity with an average horizontal distance of -0.85 mms from Achilles Tendon to Sural Nerve. Out of 64 dissected lower limbs, Type A (MSCN+LSCN) Sural nerve formation was seen in 78.1%,Type B(MSCN as Sural nerve) Sural nerve formation was seen in 14.1% and Type C (LSCN as Sural nerve ) was seen in 7.8%. Conclusion : In the present study an attempt is made to measure the exact distance at which the Sural nerve crosses the lateral border of Achilles tendon proximal to Calcaneal tuberosity and this measurement enables Surgeons to identify the location of the sural nerve with 95% confidence intervals, according to the patient’s leg length. The present study concludes that the above said anatomic knowledge will assist surgeons in preoperatively predicting where the sural nerve crosses the lateral border of the Achilles tendon, thereby minimizing the risk of iatrogenic injury to Sural nerve.