Abstract
The suture button technique can cause damage to the saphenous vein and nerve. We examined the location and course of the great saphenous vein using magnetic resonance imaging and determined its position at 10, 20, 30, or 40 mm proximal to the tibial plafond. We divided the region from the anterior to the posteromedial tibial edges into segments A, B, C, D, and E, and compared baseline data and vein parameters between 56 healthy (group H) and 296 symptomatic limbs (group D). At 10, 20, 30, and 40 mm proximal to the tibial plafond, segments A (53.4%), B (45.7%), C (50.0%), and D (52.6%), respectively, had the highest probability of the presence of the great saphenous vein. The mean angle of the great saphenous vein from the distal anterior to the proximal posterior side of the tibia in relation to the tibial axis was 32.4° ± 4.8°. There were no significant differences between groups H and D. These findings indicate that the position of the saphenous vein and nerve should be determined prior to performing the suture button technique on the medial side of the tibia. This can be achieved under direct visualization through a small skin incision or via ultrasound.
Highlights
The suture button technique can cause damage to the saphenous vein and nerve
Because the suture button technique entails affixing the medial button to the medial tibia after passing it through the bone, there is a risk of damage to the great saphenous vein and saphenous nerve
We determined the trends displayed in the course of the great saphenous vein at heights where the suture buttons are inserted for the purpose of reconstructing ankle syndesmosis
Summary
The suture button technique can cause damage to the saphenous vein and nerve. We examined the location and course of the great saphenous vein using magnetic resonance imaging and determined its position at 10, 20, 30, or 40 mm proximal to the tibial plafond. We determined the trends displayed in the course of the great saphenous vein at heights where the suture buttons are inserted for the purpose of reconstructing ankle syndesmosis.
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