An ankle arthroscopic portal most likely to damage the sural nerve is which option?

An ankle arthroscopic portal most likely to damage the sural nerve is which option?

• A. Anterolateral portal
• B. Lateral central portal
• C. Anteromedial portal
• D. Posterior portal

Answer: (B)

The main idea is understanding where the sural nerve runs in relation to ankle arthroscopy portals. The sural nerve travels along the posterior-lateral aspect of the ankle and foot, often crossing near the lateral malleolus into the lateral gutter. A lateral central portal sits right in that lateral gutter path, placing it closest to the nerve and its branches, so injury risk is highest there. In contrast, anterior portals (anteriorly placed) are farther from the sural nerve’s usual course, and a posterior portal is more posterior/medial with respect to where the sural nerve typically travels, making them less likely to injure it. Variations in nerve anatomy exist, but the lateral central portal remains the portal with the greatest risk for sural nerve injury.

The main idea is understanding where the sural nerve runs in relation to ankle arthroscopy portals. The sural nerve travels along the posterior-lateral aspect of the ankle and foot, often crossing near the lateral malleolus into the lateral gutter. A lateral central portal sits right in that lateral gutter path, placing it closest to the nerve and its branches, so injury risk is highest there. In contrast, anterior portals (anteriorly placed) are farther from the sural nerve’s usual course, and a posterior portal is more posterior/medial with respect to where the sural nerve typically travels, making them less likely to injure it. Variations in nerve anatomy exist, but the lateral central portal remains the portal with the greatest risk for sural nerve injury.