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Complications of endovenous ablation of varicose veins
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
The sural nerve is a cutaneous nerve that originates from the tibial nerve in the mid-posterior calf that travels alongside the SSV down to the lateral malleolus. The sural nerve innervates the skin of the lower half of the posterior aspect of the leg, the lateral part of the dorsum of the foot, and the lateral side of the fifth toe. The greatest risk of injury is located in the distal calf where it is in close proximity to the SSV. Damage to the sural nerve due to thermal ablation can cause numbness or significant burning and pain in the heel and lateral aspect of the foot.
Achilles tendon rupture
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Manuel Monteagudo, Pilar Martínez de Albornoz
Complications after non-surgical management of an acute or chronic Achilles rupture include deep venous thrombosis, re-rupture, and tendon elongation/calf muscle weakness. In addition open surgery may (rarely) cause hypertrophic painful scars, infection, sural nerve injury, and wound breakdown. The more common complications cited in the literature are re-rupture, deep venous thrombosis, and deep infection. In a recent meta-analysis that included twenty-nine randomised controlled trials with 2060 patients with an acute rupture of the Achilles, the mean incidence of overall major complications from all managements was 9.13% (24). The mean incidence rates from all managements of re-rupture, deep venous thrombosis, and deep infection were 5%, 2.67%, and 1.50%, respectively. Sural nerve injury is not among the most common complications as around half of cases were managed without surgery and minimal invasive surgery has lowered the incidence of sural nerve problems. In terms of relative risk, nonoperative treatment combined with early immobilisation was associated with a higher risk of major complications. According to the area under the cumulative ranking curve, minimally invasive surgery with accelerated rehabilitation had the highest possibility (79.7%) of being the best management with regard to minimising major complications (24).
Diseases of the Peripheral Nerve and Mononeuropathies
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Diana Mnatsakanova, Charles K. Abrams
At the ankle: Residual symptoms from a sural nerve biopsy.Prolonged crossing of the ankles.Ganglion.Neuroma.Fifth metatarsal bone fracture.
Exercise-induced leg pain in athletes: diagnostic, assessment, and management strategies
Published in The Physician and Sportsmedicine, 2019
Heinz Lohrer, Nikolaos Malliaropoulos, Vasileios Korakakis, Nat Padhiar
There is now broad agreement that the most common EILP sub-diagnoses will fall into one of the following categories: (a) Pain of bony origin (e.g., bone stress injury), (b) Pain of osteo-fascial origin usually along the medial border of the tibia (e.g., periostitis) often referred to as medial tibial stress syndrome (MTSS). (c) Pain of muscular origin (e.g., chronic exertional compartment syndrome = CECS) or myopathy (e.g., McArdle Syndrome). (d) Pain due to compression of a nerve (e.g., common peroneal nerve entrapment syndrome) superficial peroneal nerve entrapment syndrome, sural nerve entrapment syndrome, or tibialis posterior nerve entrapment syndrome. (e) Pain due to temporary vascular compromise (e.g., functional popliteal artery entrapment syndrome = FPAES) [2–4]. Additionally, there are several other different pathologies, overlapping and mimicking syndromes that has to be considered in the differential diagnosis of EILP (Table 1) [3–8].
Andrographolide relieved pathological pain generated by spared nerve injury model in mice
Published in Pharmaceutical Biology, 2018
Huang-Chi Wang, Hsin-Sheng Tsay, Hui-Nung Shih, Yi-An Chen, Kai-Ming Chang, Dinesh Chandra Agrawal, Siendong Huang, Yi-Lo Lin, Meng-Jen Lee
BalbC mice were subjected to peripheral neuropathy induced by sciatic nerve injury (SNI) (Decosterd and Woolf 2000). The biceps femoris muscle was exposed under isoflurane anaesthesia delivered via a nose cone (2% isoflurane with oxygen as the carrier gas). A section was made through the biceps femoris to expose the sciatic nerve and its three terminal branches: the sural, common peroneal, and tibial nerves. The common peroneal and tibial nerves were sectioned, removing 2–4 mm of the distal nerve stump. Care was taken to avoid touching or stretching the spared sural nerve. Muscle and skin were closed in two separate layers. For sham surgery, the sciatic nerve was exposed as described above but no contact was made with the nerve, on a separate rat other than the one that has branches of sciatic nerve transected. The right side was transected (ipsilateral side, i).
Corneal Neurotization: Review of a New Surgical Approach and Its Developments
Published in Seminars in Ophthalmology, 2019
Natalie Wolkow, Larissa A. Habib, Michael K. Yoon, Suzanne K. Freitag
Weis et al.19 used a similar approach in 2018 with a sural nerve graft in six patients. The ipsilateral or contralateral side was chosen as the sensory donor based on a pre-operative sensory assessment. Intraoperatively, the supraorbital or supratrochlear nerve was selected as the donor based on its size and compatibility with the sural nerve graft. The sural nerve was coapted to the supratrochlear or supraorbital nerve with 10-0 nylon sutures and fibrin sealant. The nerve fascicles were sutured to the sclera near the corneal limubs with 9-0 polyglactin sutures. Corneal sensation improved postoperatively in all six patients. Several patients had initial pain in the forehead donor site, which resolved over time.