Background: For triple arthrodesis, a single medial incision has been proposed to avoid lateral wound complications and has demonstrated satisfactory fusion rates. This study aimed to compare the disruption to the arterial supply of the talus between the single-medial-incision approach and the 2-incision approach.
Methods: The 2 approaches for triple arthrodesis were compared by analyzing the disruption of arterial vasculature in 14 cadaveric specimens in randomized fashion. The arterial disruption was determined using CT angiography before and after surgery combined with analysis from dissection. The area of joint preparation from each technique was also analyzed and compared.
Results: The single-medial-incision approach caused a high incidence of damage to the deltoid artery (6 of 7 specimens, 86%) and the artery of the tarsal canal (7 of 7 specimens, 100%). The 2-incision approach resulted in damage to the artery of the tarsal sinus in all specimens (7 of 7 specimens, 100%), but the medial vasculature was spared given the limited dissection required to access the talonavicular joint. Through the single-medial-incision approach the percentage of debridement of the calcaneocuboid joint (36%) was significantly lower than the debridement using the 2-incision approach (85%, P < .01). There was no significant difference in joint preparation of the talonavicular and subtalar joints between the 2 approaches with the number of specimens available.
Conclusion: From this cadaveric study, we found that both approaches could result in substantial disruption of the main blood supply to the talus. The single-medial-incision approach consistently disrupted the majority of blood supply to the talar body, while the 2-incision approach caused various degrees of vascular disruption to the talar head and neck. Using the single-medial-incision approach, the calcaneocuboid joint did not show adequate removal of articular cartilage due to difficulty accessing the joint surfaces.
Clinical Relevance: Vascular sparing to the talus should be considered when selecting an appropriate operative approach for triple arthrodesis. Although the clinical significance of this cadaveric study is limited, the 2-incision approach appeared to cause less vascular disruption to the talar body while allowing more complete joint preparation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/1071100713479318 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Purpose: To assess validity, safety, and efficacy of the modified triple pelvic osteotomy (TPO) approach for correction of residual acetabular dysplasia.
Methods: This is a retrospective case series conducted on 15 hips in 15 patients from 2019 to 2023 with residual acetabular dysplasia treated by modified TPO as described by Tonnis with two modifications. The first modification is using a single medial incision for pubic and ischial cuts (the Vladimirov modification).
Single Medial vs 2-Incision Approach for Double Hindfoot Arthrodesis: Is There a Difference in Joint Preparation?
Foot Ankle Int
August 2021
Department of Orthopaedics and Rehabilitation, University of Rochester, Rochester, NY, USA.
Background: Double hindfoot arthrodesis is a reliable treatment option in lower extremity deformity and arthritis. Single (medial) and 2-incision techniques have been described. The purpose of this study was to evaluate the extent of cartilage debrided in each approach and to evaluate the competency of the deltoid ligament.
View Article and Find Full Text PDFSimultaneous Compression of the Median and Ulnar Nerve at the Elbow: A Retrospective Study.
J Hand Surg Asian Pac Vol
June 2018
* 5th Orthopaedic Department, Hand and Upper Extremity Service, Asklepieion Voulas General Hospital, Athens, Greece.
Background: Simultaneous compression of the median and ulnar nerve at the elbow region has not been sufficiently highlighted in the literature. The purposes of the present study are to report our experience regarding this entity, to elucidate the clinical features, and to describe the operative technique and findings as well as the results of simultaneous decompression performed through the same medial incision.
Methods: We performed a retrospective study of thirteen elbows in thirteen patients -nine men and four women- with simultaneous compression of the median and ulnar nerve at the elbow region between 2000 and 2011.
Single incision pediatric flexible intramedullary tibial nailing.
J Orthop
September 2017
Valley Children's Hospital, 9300 Valley Children's Pl., Madera, CA 93636, USA.
Background: There has been a trend towards flexible intramedullary nailing for unstable tibial shaft fractures in the pediatric population, traditionally, utilizing a 2-incision technique with passage of one nail medially and one nail laterally. Our study aims to compare a single incision approach for flexible nailing of unstable tibial shaft fractures in pediatric patients to the traditional 2-incision approach.
Methods: Patients were selected for operative fixation if they had a length unstable tibial shaft fracture confirmed by fluoroscopy.
Arthroscopic Medial Approach for Modified Double Arthrodesis of the Foot.
J Foot Ankle Surg
August 2017
Attending Physician, Department of Orthopaedic Surgery, The Permanente Medical Group, San Leandro, CA.
The single medial incision subtalar joint and talonavicular joint arthrodesis has been shown to be a useful alternative for the correction of hindfoot valgus deformity. We describe an arthroscopic method of joint preparation using this approach. The present case report included 6 consecutive patients aged 35 to 72 (mean ± standard deviation 55.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!