The anatomy of the saphenous and sural nerves as a source of processed nerve allografts
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The anatomy of the saphenous and sural nerves as a source of processed nerve allografts Jin-Hyung Im . Joo-Yup Lee Yang-Guk Chung
. Wan-Hee Yeon . Myeong-Kyu Lee .
Received: 8 July 2019 / Accepted: 1 June 2020 Ó Springer Nature B.V. 2020
Abstract As an alternative to autologous nerve donors, acellular nerve allografts (ANAs) have been studied in many experiments. There have been numerous studies on processing ANAs and various studies on the clinical applications of ANA, but there have not been many studies on sources of ANAs. The purposes of the present study were to evaluate the course of the saphenous and sural nerves in human cadavers and help harvest auto- or allografts for clinical implications. Eighteen lower extremities of 16 fresh cadavers were dissected. For the saphenous nerve and sural nerve, the distances between each branch and the diameters at the midpoint between each branch were measured. In the saphenous nerve, the mean length between each branch ranged from 7.2 to 28.6 cm, and the midpoint diameter ranged from 1.4 to
3.2 mm. In the sural nerve, the mean length between each branch ranged from 17.4 to 21 cm, and the midpoint diameter ranged from 2.3 to 2.8 mm. The present study demonstrates the length of the saphenous and sural nerve without branches with diameters larger than 1 mm. With regard for the clinical implications of allografts, the harvest of a selective nerve length with a large enough diameter could be possible based on the data presented in the present study. Keywords Saphenous nerve Sural nerve Allograft source Acellular nerve allograft Processed nerve allograft
Introduction J.-H. Im Department of Orthopedic Surgery, Gyeongsang National University Changwon Hospital, Changwon, Korea J.-Y. Lee (&) Y.-G. Chung Department of Orthopedic Surgery, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea e-mail: [email protected] W.-H. Yeon M.-K. Lee Korea Public Tissue Bank, Seoul, Korea Y.-G. Chung Department of Orthopedic Surgery, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
Peripheral nerve segmental defects can result from trauma or tumor resection, and the standard treatment for nerve segmental defects is autologous nerve grafts. As the donors for autologous nerve grafts, the median antebrachial cutaneous nerve, the lateral cutaneous nerve, the terminal branch of the posterior interosseous nerve, and the sural nerve are considered for sensory nerve defects, and the distal anterior interosseous nerve and the nerve to the gracilis are considered for motor nerve defects. The sural nerve is the most popular donor nerve because of its superficial location and variability of harvest length, and it has been used for various regions and defect sizes. Autologous nerve
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grafts have some limitations, such as donor site morbidity, the potential for neuroma formation, diameter mismatch, length limitations, the distance to th
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