TechniquesEvaluation of Anatomic Relationship Between Sural Nerve and Instrumentation During Mini-Open Achilles Tendon Repair: A Cadaveric StudyKrautmann, Kurt MD*; Shofoluwe, Ademola MD†; Fowler, Brian BA†; Stewart, Gary W. MD‡; Badana, Adrian N.S. PhD†Author Information *Northwestern University Feinberg School of Medicine, Chicago, IL †Wellstar Atlanta Medical Center, Atlanta ‡Resurgens Orthopaedics, Resurgens Foot and Ankle Center, Morrow, GA Funding for use of 1 Arthrex Inc. jig and 10 suture packets was provided by Arthrex Inc., although they were not involved in any other way with the study or its publication. The authors declare no conflict of interest. Address correspondence and reprint requests to Adrian N.S. Badana, PhD, WellStar Atlanta Medical Center, 320 Parkway Dr NE, Atlanta, GA 30312. E-mail: [email protected]. Techniques in Foot & Ankle Surgery: September 2021 - Volume 20 - Issue 3 - p 161-164 doi: 10.1097/BTF.0000000000000286 Buy Metrics Abstract The purpose of this study was to determine the relationship of the sural nerve to the Arthrex Percutaneous Achilles Repair System (PARS) jig and repair sutures. We performed cadaveric dissection on 10 unpaired above-knee amputation specimens (6 were right legs and 4 were left legs). In all but 1 cadaver, all of the sutures either punctured the nerve or passed anterior to it. Only 1 cadaver had sutures that were posterior to the sural nerve. In all cases, removal of the jig pulled the sutures through the nerve and the nerve was completely free after locking the sutures, and the sural nerve was within 1 cm of the lateral aspect of the transverse incision made for insertion of the jig. This cadaveric study revealed a high rate of sural nerve puncture when passing needles across the Achilles tendon using a commercially available minimally invasive repair device. This finding should caution users of Arthrex PARS jig to be attentive to postoperative symptoms of nerve injury. Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.