Ultrasound assessment of the sural nerve in patients with neuropathic pain after ankle surgery

Muscle Nerve. 2018 Mar;57(3):407-413. doi: 10.1002/mus.25744. Epub 2017 Aug 13.

Abstract

Introduction: The sural nerve may be damaged after ankle injury. The aim of our study was to determine the diagnostic utility of high-resolution sonography in patients with ankle fractures treated by open reduction and internal fixation in whom there was a clinical suspicion of sural neuropathy.

Methods: We examined the ultrasound (US) characteristics of patients with and without postsurgical sural neuropathic pain and healthy volunteers. Cross-sectional area (CSA), echogenicity, and vascularization of the sural nerves were recorded.

Results: Fourteen participants and all sural nerves were identified. CSA (P < 0.001) and vascularization (P = 0.002) were increased in symptomatic patients when compared with asymptomatic patients and healthy volunteers. There were no significant differences in nerve echogenicity (P = 0.983).

Discussion: US may be a valuable tool for evaluating clinically suspected sural nerve damage after ankle stabilization surgery. Sural nerve abnormalities are seen in patients with postsurgical neuropathic pain. Muscle Nerve 57: 407-413, 2018.

Keywords: ankle surgery; neuropathy; open reduction internal fixation; sural nerve; ultrasound.

MeSH terms

  • Ankle / diagnostic imaging
  • Ankle / surgery*
  • Ankle Fractures / diagnostic imaging
  • Ankle Fractures / surgery*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Neuralgia / diagnostic imaging*
  • Sural Nerve / diagnostic imaging*
  • Ultrasonography