Didomenico Lawrence A, Anain Joseph, Wargo-Dorsey Mari
Department of Podiatry, Department of Surgery, St. Elizabeth Health Center, Youngstown, OH, USA.
J Foot Ankle Surg. 2011 Nov-Dec;50(6):668-71. doi: 10.1053/j.jfas.2011.07.006. Epub 2011 Sep 9.
A prospective investigation of the effects on the medial and lateral neurovascular structures of the rearfoot after percutaneous posterior calcaneal displacement osteotomy was performed using 20 below the knee fresh frozen cadaver specimens. This anatomic study aimed to examine the medial and lateral neurovascular structures to determine whether they were jeopardized during execution of the osteotomy. After completion of the osteotomy, the medial plantar, lateral plantar, medial calcaneal, sural, and posterior tibial neurovascular structures, along with their respective branches, were inspected for iatrogenic injury. Our findings demonstrated that the percutaneous, subperiosteal osteotomy minimized trauma to the local soft tissue envelope and protected the adjacent neurovascular structures. Because no iatrogenic injury was observed in the cadaveric specimens, we postulated that percutaneous calcaneal displacement osteotomy is a safe, predictable, and advantageous alternative compared with open techniques for osteotomy and could result in reduced postoperative complications. The results of this investigation remain to be confirmed in the clinical setting.
使用20个膝关节以下新鲜冷冻尸体标本，对经皮跟骨后移位截骨术后后足内侧和外侧神经血管结构的影响进行了前瞻性研究。这项解剖学研究旨在检查内侧和外侧神经血管结构，以确定它们在截骨术实施过程中是否受到损害。截骨完成后，检查足底内侧、足底外侧、跟骨内侧、腓肠和胫后神经血管结构及其各自分支是否存在医源性损伤。我们的研究结果表明，经皮骨膜下截骨术将对局部软组织包膜的创伤降至最低，并保护了相邻的神经血管结构。由于在尸体标本中未观察到医源性损伤，我们推测与开放性截骨技术相比，经皮跟骨移位截骨术是一种安全、可预测且有利的替代方法，并且可能会减少术后并发症。这项研究的结果仍有待在临床环境中得到证实。
