Avon Orthopaedic Centre, North Bristol Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK.
Avon Orthopaedic Centre, North Bristol Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK.
Foot Ankle Surg. 2014 Jun;20(2):135-9. doi: 10.1016/j.fas.2014.02.001. Epub 2014 Feb 21.
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.
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.
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).
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.
关节镜下三联融合术相对于开放性技术具有多项优势,但尚未广泛应用。已发表的初步技术使用五个存在神经血管风险的端口。我们的目的是评估一种替代的外侧双端口技术的安全性和有效性。
对四个尸体后足进行关节镜下三联融合准备,使用两个外侧端口。测量相关皮下神经的距离以及准备好的关节面百分比。
从中侧外侧端口到最近的腓肠神经分支的平均距离为 22.3mm(范围 20-24mm),从背外侧端口到浅表腓浅神经中间支的距离为 7.8mm(范围 4-11mm)。关节准备的平均百分比分别为:距骨头部 63%,舟骨 62%,跟骨 75%和骰骨 74%。
两个外侧关节镜端口可实现三联融合手术的充分关节准备。使用这些端口时,皮下神经的接近程度很重要。