Investigación clínica sobre pie y tobillo

Abstracto

Ankle Arthroscopy Equates Harmful Neurovascular Structures

Danish K

Ankle joint pathology is increasingly being diagnosed and treated with arthroscopy.The anteromedial (AM), anterolateral (AL), posteromedial (PM), and posterolateral (PL) portals are the four most common ones for ankle arthroscopy. Additionally, the neurovascular structures (NVS) that run along the ankle can have very different anatomical features.To determine safe zones for the scope's insertion, the NVS's distance from the ankle arthroscopic portals' anatomical landmarks was compared.26 fresh-frozen cadavers were used for the dissection, which included NVS and standard anatomical landmarks.Using a 2.7 mm arthroscope, the portals were made and checked.When attempting to quantify a scope space, the antero-medial and anterior-lateral portals had the largest margins of error, with 0.82 and 1.04 cm, respectively.With the exception of the peroneus tertius and the intermediate dorsal cutaneous nerve (IDCN), the average distance between the saphenous nerve and vein and the antero-medial portal was 1.23 cm. The comparison of the mean distances between anatomic landmarks revealed significant differences (p = 0.181, all others p 0.0001).The tibialis anterior tendon averaged 1.10 cm lateral, the peroneus tertius tendon was 1.31 cm medial, and the Achilles tendon was 0.94 cm from the medial gutter.The anatomy of the anterior lateral portal varied the most, with the peroneus tertius tendon being 0.23 cm from the IDCN.To make it easier to see the anatomy on the lateral side, this data suggests installing the medial portal first before installing the anterolateral portal.