title: Evaluation of the proprioceptive influence of the cutaneous afferents to the ankle in patients after sural nerve harvesting.
abstract: 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.
authors.affiliation: Department of Trauma and Reconstructive Surgery, University Hospital Carl Gustav Carus, Dresden, Germany. susanne.rein@web.de
authors.forename: Susanne
authors.initials: S
authors.lastname: Rein
authors.forename: Tobias
authors.initials: T
authors.lastname: Fabian
authors.forename: Kartik
authors.initials: K
authors.lastname: Krishnan
authors.forename: Stefan
authors.initials: S
authors.lastname: Benesch
authors.forename: Gabriele
authors.initials: G
authors.lastname: Schackert
authors.forename: Hans
authors.initials: H
authors.lastname: Zwipp
authors.forename: Claudia
authors.initials: C
authors.lastname: Lindner
authors.forename: Stefan
authors.initials: S
authors.lastname: Weindel
mesh_terms: 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*