Medial subtalar arthroscopy: a cadaveric study of the tarsal canal portal
Tóm tắt
To study the safety of the tarsal canal portal in medial subtalar arthroscopy. Twenty-three fresh frozen foot and ankle specimens were divided into two groups with different orientation of the portal tract. Three types of tarsal canal portals were identified. The relationships of the metal rod and the flexor digitorum longus tendon and the posterior neurovascular bundle were studied. In group A, a type 1 tarsal canal portal tract was established in seven specimens, a type 2 portal tract in three specimens, and a type 3 portal tract in two specimens. In group B, a type 1 portal tract was established in ten specimens and a type 2 portal tract in one specimen. No type 3 portal tract was established in group B. There was no statistical significance demonstrated for establishment of a type 1 portal tract and “non type 1” (type 2 or 3) portal tract in group A and group B. The average shortest distance between the rod and the posterior tibial neurovascular bundle was 7 mm in group A and 9 mm in group B. This study provides the anatomic basis for the establishment of the tarsal canal portal. There is a risk of injury to the flexor digitorum longus tendon and the posterior tibial neurovascular bundle with the tarsal canal portal, and it should be used with great caution.
Tài liệu tham khảo
Beals TC, Junko JT, Amendola A, Nickisch F, Saltzman CL (2010) Minimally invasive distraction technique for prone posterior ankle and subtalar arthroscopy. Foot Ankle Int 31:316–319
Beimers L, de Leeuw PAJ, van Dijk CN (2009) A 3-portal approach for arthroscopic subtalar arthrodesis. Knee Surg Sports Traumatol Arthrosc 17:830–834
Bonasia DE, Phisitkul P, Saltzman CL, Barg A, Amendola A (2011) Arthroscopic resection of talocalcaneal coalitions. Arthroscopy 27:430–435
Devos Bevernage B, Deleu PA, Maldague P, Leemrijse T (2010) Technique and early experience with posterior arthroscopic tibiotalocalcaneal arthrodesis. Orthop Traumatol Surg Res 96:469–475
Field C, Ng A (2009) Resection of middle facet coalition with arthroscopic guidance. J Foot Ankle Surg 48:273–276
Hammond AW, Phisitkul P, Femino J, Amendola A (2011) Arthroscopic debridement of the talonavicular joint using dorsomedial and dorsolateral portals: a cadaveric study of safety and access. Arthroscopy 27:228–234
Lui TH, Chan KB, Chan LK (2010) Portal safety and efficacy of anterior subtalar arthroscopy: a cadaveric study. Knee Surg Sports Traumatol Arthrosc 18:233–237
Lui TH, Chan LK (2010) Safety and efficacy of talonavicular arthroscopy in arthroscopic triple arthrodesis. A cadaveric study. Knee Surg Sports Traumatol Arthrosc 18:607–611
Mekhail AO, Heck BE, Ebraheim NA, Jackson WT (1995) Arthroscopy of the subtalar joint: establishing a medial portal. Foot Ankle Int 16:427–432
Phisitkul P, Tochigi Y, Saltzman CL, Amendola A (2006) Arthroscopic visualization of the posterior subtalar joint in the prone position: a cadaver study. Arthroscopy 22:511–515