title: An anatomical and cadaveric study examining the risk of sural nerve injury in percutaneous Achilles tendon repair using the Achillon device.
abstract: BACKGROUND
  Percutaneous Achilles tendon repairs are gaining in popularity. This study aims to quantify the risk of sural nerve injury when using the Achillon device.
  
  
  METHODS
  The Achillon device was instrumented into 15 cadaveric specimens and through dissection the rate of sural nerve puncture and the position of the sural nerve in relation to the Achilles tendon was documented.
  
  
  RESULTS
  The sural nerve was found lateral to the Achilles tendon insertion point over a range of 14.3mm and crossed the lateral border of the Achilles tendon over a range of 57.7mm. The sural nerve was punctured a total of 6 times and in 4 out of 15 cadaveric specimens (27%). Four out of the 6 punctures occurred when the Achillon device was instrumented distally.
  
  
  CONCLUSIONS
  The sural nerve displays a highly variable anatomical course and there is a risk of puncture during percutaneous Achilles tendon repair using the Achillon device.
authors.affiliation: St. George's Hospital, London, United Kingdom. Electronic address: kenjporter@hotmail.com.
authors.forename: Ken J
authors.initials: KJ
authors.lastname: Porter
authors.affiliation: East Kent University Hospitals, East Kent, United Kingdom.
authors.forename: Shibby
authors.initials: S
authors.lastname: Robati
authors.affiliation: St. George's Hospital, London, United Kingdom.
authors.forename: Priyesh
authors.initials: P
authors.lastname: Karia
authors.affiliation: Royal Surrey County Hospital, Guildford, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Portet
authors.affiliation: St. George's Hospital, London, United Kingdom.
authors.forename: Matthew
authors.initials: M
authors.lastname: Szarko
authors.affiliation: St. George's Hospital, London, United Kingdom.
authors.forename: Amit
authors.initials: A
authors.lastname: Amin
mesh_terms: D000125:Achilles Tendon / Q000293:injuries / Q000601:surgery*; D002102:Cadaver; D006801:Humans; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000295:instrumentation; D012307:Risk Factors; D013497:Sural Nerve / Q000033:anatomy & histology* / Q000293:injuries*; D013708:Tendon Injuries / Q000601:surgery*
keywords: Achilles tendon; Achillon; Percutaneous repair; Rupture; Sural nerve