Abstract:
The articular branch (Arb) from the common fibular nerve (CFN) plays a pivotal role in procedures such as genicular nerve blocks since it extensively innervates the anterolateral knee joint. It remains unclear whether the Arb can be classified as purely sensory, and understanding its axonal composition is critical to prevent muscle weakness during nerve blocks. We conducted a histological analysis on six cadaveric nerve specimens (four males and two females; mean age at death, 81.3 years old). The axonal composition of the main trunk of the CFN, the deep and superficial fibular nerves (DFN and SFN), and the Arb was verified through double immunofluorescence labeling with antibodies against neurofilament 200 and choline acetyltransferase. We revealed that the DFN contains motor and sensory fascicles that serve the anterior muscular compartment of the leg, including the fibularis longus and the first web space of the foot. Moreover, we showed that the SFN includes a major sensory branch innervating the skin of the lateral leg and the dorsum of the foot and a minor motor branch for the lateral muscular compartment of the leg. Furthermore, we demonstrated that the Abr contains a major sensory branch that targets the infrapatellar fat pad, the knee joint, and a minor motor branch innervating the superior part of the anterior muscular compartment of the leg. Thus, our study proves that the Arb is a motor-sensory mixed nerve, suggesting that an Arb block may significantly weaken the anterior leg muscles.
摘要:
腓总神经(CFN)的关节支(Arb)在诸如膝状神经阻滞之类的手术中起着关键作用,因为它广泛支配膝关节前外侧。尚不清楚Arb是否可以归类为纯粹的感官,并且了解它的轴突成分对于防止神经阻滞期间的肌肉无力至关重要。我们对六个尸体神经标本进行了组织学分析(四名男性和两名女性;平均死亡年龄,81.3岁)。CFN主干的轴突组成,腓深神经和腓浅神经(DFN和SFN),并通过抗神经丝200和胆碱乙酰转移酶抗体的双重免疫荧光标记验证了Arb。我们发现DFN包含运动和感觉束,服务于腿部的前肌室,包括长腓骨和脚的第一个网状空间。此外,我们表明,SFN包括一个支配外侧腿和足背皮肤的主要感觉分支,以及一个用于腿外侧肌室的次要运动分支。此外,我们证明了Abr包含一个主要的感觉分支,目标是髌下脂肪垫,膝关节,和一个小的运动分支支配腿部前肌室的上部。因此,我们的研究证明Arb是一种运动感觉混合神经,这表明Arb阻滞可能会显著削弱前腿肌肉。