After venesection of the great saphenous vein the patients presents with severe pain and hypoaesthesia in the medical side of the great toe. The nerve most commony involved is-
(Saphenous nerve): (91-92-BDC-2 6th edition)Saphenous nerve arises in the femoral triangle. It pierces the deep fascia on the medial side of the knee and descends close to the great saphenous vein, either in front or behind. It supplies the skin of most of the medial border of the foot up to the ball of the big toe. Pain radiating along the medial border of foot is therefore suggestive of accidental ligation of saphenous nerve.Great saphenous vein cutdown. A, B. At the ankle. The great saphenous vein is constantly found in front of the medial maiieolus ot tne tibia. C. D. At the groin The great saphenous vein drains into the femoral vein two fingerbreadtns below and lateral to the pubic tubercle.* The larger diameter of the vein at this site permits the use of large diameter catheters and the rapid infusion of large volumes of fluidsAnatomy of Ankle vein cut downThe procedure is as follows1. The sensory nerve supply to the skin immediately in front of the medial malleolus of the tibia is from branches of the saphenous nerve, a branch of the femoral nerve. The saphenous nerve branches are blocked with local anesthetic2. A transverse incision is made through the skin and sub cutaneous tissue across the long axis of the vein just anterior and superior to the medial malleolus. Although the vein may not be visible through the skin. It is constantly found at this site3. The vein is easily identified and the saphenous nerve should be recognized, the nerve usually lies just anterior to the vein
Saphenous nerve
Planter nerve
Deep peroneal nerve
Superficial peroneal nerve
Lower Extremity