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Safe Zone for the Plantar Portal: A Cadaveric Study.
Shingo Maeda1, Hisateru Niki2, Takaaki Hirano2
1Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan shingo10082003@yahoo.co.jp.
Foot & Ankle International
|November 6, 2015
Summary
Endoscopic surgery of the sole is safer with a plantar lateral portal for peroneus longus tendoscopy. Anatomical study identified safe zones for plantar portals, minimizing risks to nerves.
Area of Science:
- Anatomy
- Surgical Procedures
- Biomechanics
Background:
- Plantar nerve anatomy is critical for safe endoscopic sole surgery.
- Cadaveric dissection is essential for mapping surgical safety zones.
Purpose of the Study:
- To investigate the safety of peroneus longus tendoscopy using a plantar lateral portal.
- To identify safe zones for plantar portals in endoscopic foot surgery.
Main Methods:
- Dissection of 36 cadaveric feet (24 individuals).
- Cannula insertion from plantar lateral portal to peroneus longus tendon.
- Observation of relationships between cannula, sural nerve, and plantar nerve.
- Digital imaging and analysis of plantar nerve course.
Main Results:
- Plantar lateral portal creation is relatively safe, with a mean minimum distance of 13.8 mm to the sural nerve.
- The lateral plantar nerve is in a different tissue layer, ensuring safety during peroneal tendon evaluation.
- A safe zone for plantar portals was identified between 36.4% and 56% along the medial-to-proximal fifth metatarsal line.
Conclusions:
- Peroneus longus tendoscopy from a plantar lateral portal is relatively safe.
- A plantar central portal may be safely created in the medial sole, avoiding neurovascular structures.
- Plantar portals offer enhanced visualization and treatment options for sole endoscopic surgery.
