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A Teleoperated Robotic System-Assisted Percutaneous Transiliac-Transsacral Screw Fixation Technique
Published on: January 6, 2023
Risk to neurovascular structures using posterolateral percutaneous ankle screw placement: a cadaver study
1Department of Orthopaedics, Union Memorial Hospital, Baltimore, MD 21218, USA.
Foot & Ankle International
|June 15, 2007
Summary
Percutaneous screw placement for ankle fusion is safe, with minimal risk to nerves when standard technique is used. Careful guide pin placement is essential to avoid potential injury to the sural and tibial nerves.
Area of Science:
- Orthopedic Surgery
- Anatomy
Background:
- Ankle arthrodesis using screw augmentation is a common procedure for treating arthritic ankles.
- Understanding potential neurovascular risks associated with percutaneous guide pin placement is crucial.
Purpose of the Study:
- To evaluate the risks to local neurovascular structures during percutaneous guide pin placement for ankle arthrodesis.
Main Methods:
- A cadaver study using nine fresh frozen limbs.
- Percutaneous placement of a guide pin into the distal posterolateral leg.
- Layered dissection to assess neurovascular proximity and potential injury.
Main Results:
- The guide pin did not injure the sural or tibial nerves in any specimens.
- Mean closest distances were 0.9 mm to the sural nerve and 6.5 mm to the tibial nerve.
Conclusions:
- Standard percutaneous screw placement for ankle fusion is safe with minimal neurovascular risk.
- Posterolateral guide pin placement should be lateral to avoid sural nerve injury.
- Tibial nerve injury is a risk if the pin crosses the coronal plane midline.
