Evaluation of the proprioceptive influence of the cutaneous afferents to the ankle in patients after sural nerve harvesting.
OBJECTIVE
Cutaneous afferent nerves contribute to joint proprioception. The aim of this study was to retrospectively analyze the proprioceptive influence of the cutaneous afferents to the ankle in patients after sural nerve harvesting in comparison to controls.


METHODS
The proprioception of the ankle in 24 patients after sural nerve harvesting was investigated. The sural nerve was harvested bilaterally in Group 1 (n = 10), in the right leg in Group 2 (n = 6), and in the left leg in Group 3 (n = 8). The proprioception of the ankle was also tested in controls (Group 4, n = 24). The peroneal reaction time (PRT) was measured on a tilting platform. The position sense test was performed. Balance control was investigated with the Biodex Stability System (Biodex Medical Systems, Shirley, NY) at the stable Level 8 and unstable Level 2.


RESULTS
No significant differences among the groups were seen in the position sense test, the PRT, and all scores of the Biodex Stability System. The PRT showed significant differences in comparison to the contralateral leg for the peroneus brevis muscle in Group 1 (P = 0.005) and Group 4 (P = 0.001) as well as for the peroneus longus muscle in Group 3 (P = 0.036) and Group 4 (P = 0.001).


CONCLUSIONS
The proprioception of the ankle in patients after sural nerve harvesting is not reduced in comparison to controls. Significant differences of the PRT between the left and right legs are attributable to leg dominance in most cases and not to a loss of innervation. Harvesting of the sural nerve does not result in ankle instability.
Rein
Susanne
S
Department of Trauma and Reconstructive Surgery, University Hospital Carl Gustav Carus, Dresden, Germany. susanne.rein@web.de
Fabian
Tobias
T
Krishnan
Kartik
K
Benesch
Stefan
S
Schackert
Gabriele
G
Zwipp
Hans
H
Lindner
Claudia
C
Weindel
Stefan
S
D000328:Adult; D000344:Afferent Pathways / Q000503:physiopathology*; D000843:Ankle Joint / Q000294:innervation* / Q000503:physiopathology*; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology; D008297:Male; D011434:Proprioception; D012867:Skin / Q000294:innervation* / Q000503:physiopathology*; D013497:Sural Nerve / Q000503:physiopathology* / Q000637:transplantation*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods*