Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/22721
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Type: Journal article
Title: Anatomical study of the ankle with view to the anterior arthroscopic portals
Author: Solomon, L.
Ferris, L.
Henneberg, M.
Citation: Australian and New Zealand Journal of Surgery, 2006; 76(10):932-936
Publisher: Blackwell Science Asia
Issue Date: 2006
ISSN: 1445-1433
1445-2197
Statement of
Responsibility: 
Lucian B. Solomon, Linda Ferris and Maciej Henneberg
Abstract: This article evaluates the risk of interference with the neurovascular structures in the four anterior ankle arthroscopic portals, described on each side of the extensor tendons: anteromedial, medial midline, anterocentral and anterolateral. Complications after ankle arthroscopies have been described in up to 17%, most being neurovascular. To quantify the neurovascular risks we dissected 68 cadaveric feet and evaluated the correlations between tendons, vessels and nerves. The mean distance between tibialis anterior and extensor hallucis longus and between extensor hallucis longus and extensor digitorum longus is 4 mm, but in 10–20% these tendons are in apposition or are overlapped. The tibialis anterior vascular bundle was absent in 11.8%, was located between the tibialis anterior and the extensor hallucis longus in 3% and between the extensor hallucis longus and the extensor digitorum longus in 64.7%. A peroneal vascular bundle or branches of the tibialis anterior vascular bundle were located lateral to the extensor digitorum longus/peroneus tertius tendon in 88.2%. Transverse vascular branches were identified in 41.2% over the medial side of the joint line and in 52.9% over the lateral side. The deep peroneal nerve was located between the extensor hallucis longus and the extensor digitorum longus tendons in 58.8%. The superficial peroneal nerve had branches located between the tibialis anterior and the extensor hallucis longus tendons in 2.9%, between the extensor hallucis longus and the extensor digitorum longus tendons in 23.5% and lateral to the extensor digitorum longus/peroneus tertius tendon in 32.4%. These results show that the anteromedial and medial midline portals are the safest. The anterolateral portal should be noted not only for the risks to the superficial peroneal nerve, but also to the peroneal vessels.
Keywords: neurovascular risk; anterior arthroscopic portal; ankle
Description: The definitive version is available at www.blackwell-synergy.com
RMID: 0020061411
DOI: 10.1111/j.1445-2197.2006.03909.x
Appears in Collections:Anatomical Sciences publications

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