The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
Howard M Clarke - One of the best experts on this subject based on the ideXlab platform.
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evaluation of the sensory deficit after Sural Nerve harvesting in pediatric patients
Plastic and Reconstructive Surgery, 2007Co-Authors: Oren Lapid, Emily S Ho, Cristina Goia, Howard M ClarkeAbstract:BACKGROUND: The Sural Nerve is a sensory Nerve that innervates the proximal part of the lateral aspect of the foot. The Sural Nerve is often harvested for Nerve grafting. Sensory loss in the area supplied by the Sural Nerve could be expected, causing a lack of protective sensation and a potential risk of injury. The sensory outcome of Sural Nerve harvesting has not been documented in children. The aim of this study was to evaluate the sensory deficit following Sural Nerve harvest in infants. METHODS: The authors conducted a controlled study. Evaluation and mapping of the sensory thresholds in the Sural Nerve distribution were performed using the Semmes-Weinstein monofilament method on four predetermined sites on the foot. A questionnaire was used to elicit subjective findings. The inclusion criteria were children older than 6 years who had undergone bilateral Sural Nerve harvesting for brachial plexus reconstruction in the first year of life. Normal volunteers served as controls. RESULTS: Fourteen patients and 14 controls were enrolled in the study. Eighty-six percent of the feet that were operated on had a sensory deficit (p = 0.0001). The patients reported no concerns regarding the sensation of their feet. CONCLUSIONS: Sural Nerve harvesting in children leaves a measurable sensory deficit; however, this deficit does not seem to have clinical implications for the patients.
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Evaluation of the sensory deficit after Sural Nerve harvesting in pediatric patients.
Plastic and reconstructive surgery, 2007Co-Authors: Oren Lapid, Cristina Goia, Howard M ClarkeAbstract:Background:The Sural Nerve is a sensory Nerve that innervates the proximal part of the lateral aspect of the foot. The Sural Nerve is often harvested for Nerve grafting. Sensory loss in the area supplied by the Sural Nerve could be expected, causing a lack of protective sensation and a potential ris
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Endoscopic Sural Nerve harvest in the pediatric patient
Plastic and reconstructive surgery, 1996Co-Authors: Lucie Capek, Howard M Clarke, Ronald M. ZukerAbstract:A technique of endoscopic Sural Nerve harvest was devised to minimize the donor-site scarring in pediatric patients requiring peripheral Nerve-grafting procedures. The harvests were performed under tourniquet control using two 2-cm incisions for access at the lateral malleolus and the midcalf. Endoscopic visualization and blunt dissection of the Nerve were achieved with a 4-mm Hopkins telescope with 30-degree angled lens (Karl Storz GmbH, Tuttlingen, Germany) stabilized in an Emory retractor and attached to a video camera. The medial Sural Nerve was divided in the popliteal fossa proximally under endoscopic visualization. The lateral Sural Nerve was identified and harvested when present. Between June of 1994 and March of 1995, 18 patients underwent 27 Sural Nerve harvests using the endoscopic technique. Mean patient age was 3.3 years (range 4 to 197 months). Indications for surgery included obstetrical brachial plexus palsy (12), facial palsy (5), and ulnar Nerve neuroma (1). Nerve-graft length harvested ranged from 13 to 41 cm. Mean tourniquet time per limb was 92 minutes. No Nerve graft injury was noted on examination under the operating microscope. Postoperative pain, swelling, and ecchymosis were minimal. Donorsite scarring has been aesthetically satisfactory to date.
S K Orourke - One of the best experts on this subject based on the ideXlab platform.
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a clinical test to avoid Sural Nerve injuries in percutaneous achilles tendon repairs
Orthopaedic Proceedings, 2008Co-Authors: Rt Flavin, R Gibney, S K OrourkeAbstract:Introduction: Percutaneous repairs of Achilles tendon ruptures has gained popularity due the reduced incidence of wound complications, however its use is still limited by the high incidence of Sural Nerve injuries associated with these repairs. The only technique described to avoid this adverse event is to surgically expose the Nerve peri – operatively. Materials & Methods: In our study we describe and validate a clinical technique to identify the Sural Nerve. The technique describes flexing the knee to 90°, and supinating the forefoot and inverted the hindfoot. The Sural Nerve is at its greatest tension in this position and thus the Nerve can be palpated along its path. The Sural Nerve was mapped using this technique both clinically and by US in a cohort of male subjects with intact Achilles tendons. Results: We demonstrated an excellent correlation between the clinical and US mapping. It also showed excellent inter – observer and intra – observer mapping rates. Discussion: Sural Nerve injuries occur in up to 18% of percutaneous repairs due to the close proximity of the Nerve to the tendon along its lateral border. The resultant pain or parasthesia experienced by the patient from Sural Nerve injuries results in a profound morbidity. This morbidity has lead to the reduced popularity of this procedure. The clinical mapping is a simple easy test, which identifies the Nerve along its path and thus the Nerve can be avoided during the procedure. Conclusion: This study demonstrates an accurate and repeatable clinical technique for mapping the Sural Nerve in conjunction with percutaneous Achilles tendon repairs.
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a clinical test to avoid Sural Nerve injuries in percutaneous achilles tendon repairs
Injury-international Journal of The Care of The Injured, 2007Co-Authors: Rt Flavin, R Gibney, S K OrourkeAbstract:Percutaneous repairs of Achilles tendon ruptures has gained popularity due the reduced incidence of wound complications, however its use is still limited by the high incidence of Sural Nerve injuries associated with these repairs. The only technique described to avoid this adverse event is to surgically expose the Nerve peri-operatively. In our study, we describe and validate a clinical technique to identify the Sural Nerve. The Sural Nerve was mapped using this technique both clinically and by Ultrasound (US) in a cohort of male subjects with intact Achilles tendons. We demonstrated an excellent correlation between the clinical and US mapping. This study demonstrates an accurate and repeatable clinical technique for mapping the Sural Nerve in conjunction with percutaneous Achilles tendon repairs.
Oren Lapid - One of the best experts on this subject based on the ideXlab platform.
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evaluation of the sensory deficit after Sural Nerve harvesting in pediatric patients
Plastic and Reconstructive Surgery, 2007Co-Authors: Oren Lapid, Emily S Ho, Cristina Goia, Howard M ClarkeAbstract:BACKGROUND: The Sural Nerve is a sensory Nerve that innervates the proximal part of the lateral aspect of the foot. The Sural Nerve is often harvested for Nerve grafting. Sensory loss in the area supplied by the Sural Nerve could be expected, causing a lack of protective sensation and a potential risk of injury. The sensory outcome of Sural Nerve harvesting has not been documented in children. The aim of this study was to evaluate the sensory deficit following Sural Nerve harvest in infants. METHODS: The authors conducted a controlled study. Evaluation and mapping of the sensory thresholds in the Sural Nerve distribution were performed using the Semmes-Weinstein monofilament method on four predetermined sites on the foot. A questionnaire was used to elicit subjective findings. The inclusion criteria were children older than 6 years who had undergone bilateral Sural Nerve harvesting for brachial plexus reconstruction in the first year of life. Normal volunteers served as controls. RESULTS: Fourteen patients and 14 controls were enrolled in the study. Eighty-six percent of the feet that were operated on had a sensory deficit (p = 0.0001). The patients reported no concerns regarding the sensation of their feet. CONCLUSIONS: Sural Nerve harvesting in children leaves a measurable sensory deficit; however, this deficit does not seem to have clinical implications for the patients.
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Evaluation of the sensory deficit after Sural Nerve harvesting in pediatric patients.
Plastic and reconstructive surgery, 2007Co-Authors: Oren Lapid, Cristina Goia, Howard M ClarkeAbstract:Background:The Sural Nerve is a sensory Nerve that innervates the proximal part of the lateral aspect of the foot. The Sural Nerve is often harvested for Nerve grafting. Sensory loss in the area supplied by the Sural Nerve could be expected, causing a lack of protective sensation and a potential ris
Cristina Goia - One of the best experts on this subject based on the ideXlab platform.
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evaluation of the sensory deficit after Sural Nerve harvesting in pediatric patients
Plastic and Reconstructive Surgery, 2007Co-Authors: Oren Lapid, Emily S Ho, Cristina Goia, Howard M ClarkeAbstract:BACKGROUND: The Sural Nerve is a sensory Nerve that innervates the proximal part of the lateral aspect of the foot. The Sural Nerve is often harvested for Nerve grafting. Sensory loss in the area supplied by the Sural Nerve could be expected, causing a lack of protective sensation and a potential risk of injury. The sensory outcome of Sural Nerve harvesting has not been documented in children. The aim of this study was to evaluate the sensory deficit following Sural Nerve harvest in infants. METHODS: The authors conducted a controlled study. Evaluation and mapping of the sensory thresholds in the Sural Nerve distribution were performed using the Semmes-Weinstein monofilament method on four predetermined sites on the foot. A questionnaire was used to elicit subjective findings. The inclusion criteria were children older than 6 years who had undergone bilateral Sural Nerve harvesting for brachial plexus reconstruction in the first year of life. Normal volunteers served as controls. RESULTS: Fourteen patients and 14 controls were enrolled in the study. Eighty-six percent of the feet that were operated on had a sensory deficit (p = 0.0001). The patients reported no concerns regarding the sensation of their feet. CONCLUSIONS: Sural Nerve harvesting in children leaves a measurable sensory deficit; however, this deficit does not seem to have clinical implications for the patients.
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Evaluation of the sensory deficit after Sural Nerve harvesting in pediatric patients.
Plastic and reconstructive surgery, 2007Co-Authors: Oren Lapid, Cristina Goia, Howard M ClarkeAbstract:Background:The Sural Nerve is a sensory Nerve that innervates the proximal part of the lateral aspect of the foot. The Sural Nerve is often harvested for Nerve grafting. Sensory loss in the area supplied by the Sural Nerve could be expected, causing a lack of protective sensation and a potential ris
P E Ochsner - One of the best experts on this subject based on the ideXlab platform.
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avoiding Sural Nerve injuries during percutaneous achilles tendon repair
American Journal of Sports Medicine, 2006Co-Authors: Martin Majewski, Markus Rohrbach, Stephan Czaja, P E OchsnerAbstract:BackgroundSural Nerve injury is a reported risk during percutaneous repair of the Achilles tendon.HypothesisExposure of the Sural Nerve during percutaneous repair can minimize the risk of Nerve injury.Study DesignCase control study; Level of evidence, 3.MethodsThe authors retrospectively examined the results of 84 patients who were treated for acute Achilles tendon rupture at 2 different hospitals. Both hospitals used the same percutaneous repair technique, except that the Sural Nerve was exposed in the 38 patients (mean age, 38 years; range, 23-68 years) of one hospital; the Nerve was not exposed in the 46 patients (mean age, 42 years; range, 24-71 years) of the other hospital (the nonexposure group).ResultsAll patients recovered and returned to work after 44 days (range, 5-202 days). All patients returned to their previous sports levels within 1 year. On the 100-point Hannover Achilles Tendon Score, the mean score was 81 points (range, 44-100 points). The overall incidence of Sural Nerve related complic...
