Adrian M Hughes1, Oliver Gosling2, James McKenzie2, Rouin Amirfeyz3, Ian G Winson2. 1. Avon Orthopaedic Centre, North Bristol Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK. Electronic address: adrianhughes42@gmail.com. 2. Avon Orthopaedic Centre, North Bristol Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK. 3. University Hospitals Bristol, Bristol Royal Infirmary, UK.
Abstract
BACKGROUND: Arthroscopic triple fusion has several advantages over open techniques, but its use has yet to become widespread. Preliminary published techniques use five portals with neurovascular risk. Our aim was to assess the safety and efficacy of an alternative lateral two portal technique. METHODS: Four cadaveric hindfeet were arthroscopically prepared for a triple fusion using two lateral portals. The distance to relevant subcutaneous nerves was measured as well as the prepared joint surface percentage. RESULTS: Mean distance from mid-lateral portal to the nearest sural nerve branch was 22.3mm (range 20-24mm) and from the dorsolateral portal to the intermediate branch of the superficial peroneal nerve was 7.8mm (range 4-11mm). Mean percentages of joint preparation were 63% (talar head), 62% (navicular), 75% (calcaneum) and 74% (cuboid). CONCLUSIONS: Two lateral arthroscopic portals allow adequate joint preparation for triple fusion procedures. The proximity of subcutaneous nerves is important to appreciate when using these portals.
BACKGROUND: Arthroscopic triple fusion has several advantages over open techniques, but its use has yet to become widespread. Preliminary published techniques use five portals with neurovascular risk. Our aim was to assess the safety and efficacy of an alternative lateral two portal technique. METHODS: Four cadaveric hindfeet were arthroscopically prepared for a triple fusion using two lateral portals. The distance to relevant subcutaneous nerves was measured as well as the prepared joint surface percentage. RESULTS: Mean distance from mid-lateral portal to the nearest sural nerve branch was 22.3mm (range 20-24mm) and from the dorsolateral portal to the intermediate branch of the superficial peroneal nerve was 7.8mm (range 4-11mm). Mean percentages of joint preparation were 63% (talar head), 62% (navicular), 75% (calcaneum) and 74% (cuboid). CONCLUSIONS: Two lateral arthroscopic portals allow adequate joint preparation for triple fusion procedures. The proximity of subcutaneous nerves is important to appreciate when using these portals.
Authors: Sergio Tejero; Andres Carranza-Pérez-Tinao; Maria Dolores Zambrano-Jiménez; Estefanía Prada-Chamorro; Jose Juan Fernández-Torres; Andrés Carranza-Bencano Journal: Int Orthop Date: 2020-09-01 Impact factor: 3.075