DENERVATION OF THE ANKLE JOINT

¹ University of Buffalo School of Medicine and the Orthopaedic Department of the Buffalo General Hospital

It is believed that effective denervation of the ankle joint can be accomplished by transection of the articular branches from the posterior tibial and deep peroneal nerves together with sectioning of the lateral terminal division of the deep peroneal nerve. The motor loss from such a procedure, involving only the extensor digitorum brevis, is negligible.

From the evidence at hand it would seem that development of a neuropathic joint is theoretically impossible. In practice, this has been borne out in denervation operations on other joints, including neurectomies for the entire lower leg and foot, which incidentally would render the ankle joint anaesthetic. There have been no reports in the literature of development of neuropathic joints following such operations.

The operation is not presented as a panacea. It will not replace arthrodesis as the method of treatment in the severe arthritides or in patients with instability of the ankle joint. The early success in the cases reported here is worthy of consideration. A relatively simple operation, effective in alleviating symptoms, may be substituted for fusion in selected cases.

The value of the procedure can be determined only by a more extensive series, which will also develop criteria for its use.

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