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Abstract
In this study, we developed a novel technique to harvest the sural nerve using the mini incisions and the carpal tunnel dilators. The technique was applied to the 29 sides on 27 patients (24 men and 3 women). The mean age was 27.1 years (range 9-51). The diagnoses were soft tissue traumas in 23 cases, fracture in 2 cases, and previous complicated operation in 2 cases. The harmful effects of harvest procedure on the sural nerve graft were assessed double-blind histopathologically and compared with control group. All the nerve grafts were successfully harvested with no macroscopic damage to the sural nerve graft. There was no statistically significant difference between the histopathologic scores of the distal and proximal nerve segments (p>0.05). The average follow-up time was 17 months (range 8-46). In the postoperative period, no complication such as massive bleeding/hematoma, wound infection, skin necrosis, painful neuroma formation, or prolonged calf tenderness was observed. In all cases, there were inconspicuous scars. The method seems safe and has no damage on the nerve graft histopathologically. We believe that this technique may be used in future.
Highlights
The sural nerve is a pure sensory cutaneous nerve that innervates the posterolateral aspect of the leg and foot
We provided the most distal segment of the sural nerve graft as a control at the beginning of the surgical procedure, which was never affected from the traction force
All the nerve grafts were successfully harvested with no macroscopic damage to the sural nerve graft
Summary
The sural nerve is a pure sensory cutaneous nerve that innervates the posterolateral aspect of the leg and foot. The sural nerve graft is the most often used [2] donor nerve with its advantages like easy dissection, adequate length, and calibration [3, 4]. Several methods, such as open, stair-step or stepladder and endoscopic techniques, have been introduced in the literature to harvest the sural nerve [5, 6]. The nerve is harvested through a long incision that may lead to a conspicuous scar This is a major drawback of this method. We need a new sural nerve harvest technique with minimal drawbacks
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