Abstract
Arthroscopy is an important and minimally invasive diagnostic and therapeutic tool.
However, the risk of injury to the neurovascular structures around the portals exists
during arthroscopy of the ankle. In the present study, we measured the distance between
each portal and the adjacent neurovascular structures with the foot in plantarflexion
and dorsiflexion in the Japanese population. Standard anterolateral (AL), anteromedial,
posterolateral (PL), and posteromedial portal positions were identified in 6 fresh
adult cadaveric feet. The skin was dissected from the underlying tissue to visualize
the adjacent neurovascular structures as noninvasively as possible. The superficial
peroneal nerve was the structure closest to an anterior (i.e., AL) portal (3.2 ± 4.2
and 8.3 ± 3.9 mm in plantarflexion and 5.2 ± 4.3 and 10.8 ± 4.1 mm in dorsiflexion),
followed by the saphenous nerve and great saphenous vein (SpV). The distance from
the superficial peroneal nerve to the AL portal and from the saphenous nerve and great
SpV to the anteromedial portal increased significantly with dorsiflexion and decreased
significantly with plantarflexion. The sural nerve was the structure closest to the
posterior (i.e., PL) portal (10.4 ± 4.8 mm in plantarflexion and 8.5 ± 3.9 mm in dorsiflexion),
followed by the lesser SpV. The distance from the sural nerve, saphenous nerve, and
lesser SpV to the PL portal and from flexor hallucis longus, posterior tibial artery,
and tibial nerve to the posteromedial portal increased significantly in plantarflexion
and decreased significantly in dorsiflexion. These findings could help to prevent
damage to the neurovascular structures during ankle arthroscopy.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: March 13, 2018
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
