BACKGROUND: The sural nerve is a somatosensory nerve that provides sensation to the posterolateral aspect of the lower leg and the lateral part of the ankle and foot. Due to its location and anatomical properties, it is often used as an autologous nerve graft. However, the nerve harvest can be complicated by the presence of side branches. The objective of this study was to investigate the anatomy of the sural nerve and to map its side branches. This information can be used to predict the localization of separate incisions during the stair-step incisions technique for nerve harvest, thereby reducing the risk of complications. METHODS: The study involved the dissection of 50 adult cadaveric legs (25 left and 25 right) obtained from 27 Central European cadavers. The focus of the dissection was to identify the sural nerve, small saphenous vein, and surrounding anatomical structures. Detailed measurements were taken on the side branches of the sural nerve, tributaries of the small saphenous vein, and their interrelationship. RESULTS: The average number of sural nerve side branches in a single leg was 4.2±1.9. These side branches were categorized into six groups based on their location and course: mediodistal, medioproximal, lateroproximal, laterodistal, medial perpendicular, and lateral perpendicular. Specific patterns of combination of these side branches were also identified and described. The branching point of the sural nerve was found to be 5.8±2.7 cm proximal to the lateral malleolus, whereas the small saphenous vein branching point was located more distally, 4.5 ± 2.8 cm proximal to the lateral malleolus. The highest density of sural nerve side branches was found 2.1-6.0 cm above the lateral malleolus. CONCLUSION: This study presents valuable data about the relationship between the sural nerve and the surrounding anatomical structures in the distal part of the leg, including the identification of its side branches and their relevance during nerve harvest procedures. On the basis of the most frequent locations of side branches, a three-incision-technique for nerve harvest is proposed.

• MeSH
• bérec * inervace   anatomie a histologie   MeSH
• disekce MeSH
• lidé středního věku MeSH
• lidé MeSH
• mrtvola * MeSH
• nervus suralis * anatomie a histologie   MeSH
• odběr tkání a orgánů metody   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vena saphena anatomie a histologie   inervace   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Žilní systém dolních končetin je tvořen dvěma vzájemně propojenými celky. Hluboký žilní systém, jehož průběh kopíruje tepenné zásobení a jenž se vlévá do pánevních žil, a povrchový žilní systém skládající se z vena saphena magna et vena saphena parva, mezi nimiž jsou přítomné četné variabilní spojky. Povrchový a hluboký systém jsou navzájem propojeny žilními perforátory. Při nefunkčnosti perforátorů dochází ke vzniku žilních městků. Povrchové žíly jsou ve svém průběhu doprovázeny povrchovými nervy. Průběh struktur vykazuje značnou variabilitu, jež je stále předmětem zkoumání. Vena saphena magna je na bérci doprovázena nervus saphenus, který senzitivně inervuje ventromediální stranu bérce. Poranění nervus saphenus se projevuje výpadkem čití nebo hyperestéziemi, což je pacienty vnímáno velmi negativně. Vena saphena parva běží po lýtku společně s nervus suralis, jenž je častým zdrojem pro štěpy při rekonstrukčních operacích.

The venous system of the lower limbs consists of two interconnected units. A deep venous system, the course of which mimics the arterial supply and flows into the pelvic veins, and a superficial venous system, consisting of the vena saphena magna et vena saphena parva, between which there exist numerous variable comunnications. The superficial and deep systems are interconnected by venous perforators. When the perforators are non-functional, venous varices develop. Superficial veins are accompanied by cutaneous nerves. The course of structures shows considerable variability, which is still under investigation. The vena saphena magn is accompanied along the leg by the nervus saphenus, which innervates skin on the ventromedial aspect of the leg. Injury to the nervus saphenus manifests by loss of sensitivity or hyperesthesia, which is very uncomfortable for the patients. Vena saphena parva runs together with the nervus suralis, which serves for neural grafts during reconstruction surgery.

• MeSH
• dolní končetina * anatomie a histologie   inervace   krevní zásobení   MeSH
• lidé MeSH
• periferní nervový systém anatomie a histologie   krevní zásobení   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• přehledy MeSH

This article is the fourth and last part of a series aimed at extending and correcting the anatomical nomenclature. Because of the rapid development of internet and the use of electronic formats in communication in anatomy, embryology, histology, medical education, and clinical medicine, an appropriate, precise, and concise anatomical nomenclature is required. Such tool enables to avoid any potential confusion and possible scientific/medical mistakes. The up-to-date official anatomical terminology, Terminologia Anatomica, is available longer than 20 years and needs to be refined and extended. The authors have collected and listed 210 terms and completed them with definitions and/or explanations. We aimed to start a discussion about their potential incorporation into the new revised version of the Terminologia Anatomica. This article is primarily focused on the vessels of the human body (arteries, veins, and lymphatic system).

• MeSH
• anatomie * MeSH
• cévy anatomie a histologie   MeSH
• lidé MeSH
• terminologie jako téma MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH