Neurovascular Structures at Risk During Arthroscopic Approaches to the Ankle. A Cadaveric Study.

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Alejandra Nohemí Hernández-Rodríguez; Rodolfo Morales-Avalos; Salvador Galindo de-León; María del Carmen Theriot-Giron; Félix Vilchez-Cavazos; Rodrigo E. Elizondo-Omaña & Santos Guzmán-López


In the last three decades the procedure of ankle arthroscopy has increased in ankle surgery. It is preferred to open surgery for multiple reasons, the most important is that it has fewer complications, with a prevalence of 7.3 % for arthroscopy and 15.9 % for open surgery. Previous studies of ankle arthroscopy reported general complications between 0.9 to 17 % which involved cutaneous nerves at a rate of 33 to 50 %, mainly the superficial peroneal nerve. The principal objective of this study was to determi- ne the neurovascular structures near the arthroscopic portals of the ankle. We carried out anatomical, observational, trans- versal and descriptive studies. This study was performed with 10 ankles of Mexican population. A 4 mm trocar was introduced in some of the portals described in the literature and superficial dissection of the feet was made. Subsequently, the distance between the nearest neurovascular structures was measured, and statistical analysis of the results was realized. The results of the anatomic study was that the an- terior-medial portal was considered the safest portal because it has the highest distance between the portal and the neurovascular structure, with an average of 11.30 mm±11.25, the posterior-medial portal has the smallest average with 2.84 mm±1.28. A lesion of the small saphenous vein was reported in 10 % of the lateral portals. The antero-medial portal is the safest but with highest variability regarding the distances of the neurovascular structures to the portal and the postero- medial portal has the highest risk due to the increased presence of neurovascular structures.

KEY WORDS: Arthroscopy; Ankle; Structures at risk; Cutaneous Nerves; Anatomy.

How to cite this article

HERNÁNDEZ-RODRÍGUEZ, A. N.; MORALES- AVALOS, R.; DE-LEÓN, S. G.; THERIOT-GIRON, M. C.; VILCHEZ-CAVAZOS, F.; ELIZONDO-OMAÑA, R. E. & GUZMÁN-LÓPEZ, S. Neurovascular structures at risk during arthroscopic approaches to the ankle. A cadaveric study. Int. J. Morphol., 34(4):1308-1312, 2016.