Challenge of the Week / Foot & Ankle / 11.13.2020

A 22-year-old male patient undergoes a percutaneous Achilles tendon repair. After surgery, the patient reports decreased sensation in his foot. Based on the repair technique, which of the following locations will most likely be numb?
    • Dorsal foot at the 1st web space
    • The deep peroneal nerve is not at risk with this particular repair technique so there will be no numbness in this area

 

    • Lateral foot along the 5th ray
    • The sural nerve courses from a slightly medial position to a lateral position as it progresses down the posterior leg. Typically, it is located just lateral to the Achilles tendon at the rupture site and is at risk during Achilles repair

 

    • Dorsal medial foot along the 1st ray
    • The dorsal medial cutaneous branch of the superficial peroneal nerve is not at risk during this procedure. Injury to this nerve is more common with bunion surgery

 

    • Over the medial malleolus
    • The saphenous nerve is at minimal risk with Achilles tendon surgery.

     

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