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Cadaveric Study on the Safety of Medial versus Anterocentral Portals in Ankle Arthroscopy: A Comparative Analysis
Arvind Karoria1, Mayank Pratap Singh2, Deependra Dubey1
1Department of Orthopaedics, SRVS Medical College Shivpuri, Madhya Pradesh, India.
Introduction:
The medial midline portal and anterocentral both are not standard portals for ankle arthroscopy, but they provide a wide field of vision.
Aims:
The aim of this study was to compare anatomical safety between medial midline and anterocentral portal in arthroscopy in respect to the least injury to adjacent structures.
Materials And Methods:
20 cadaveric ankles were dissected and related anatomical structures were measured from anterocentral and medial midline portals.
Results:
The dorsalis pedis artery (DPA) was at a mean distance of 10.08 mm, the deep peroneal nerve was at 16.20 mm, the tibialis anterior tendon was at 2.41 mm, and the extensor hallucis longus (EHL) tendon was at 2.62 mm from the medial midline portal. The EHL tendon was injured in two specimens during portal placement. The anterocentral portal was placed at a mean distance of 2.38 mm from the DPA, 7.09 mm from the superficial peroneal nerve, and 4.12 mm from the deep peroneal nerve.
Conclusion:
Our study demonstrated that the anterocentral portal is safer than the medial midline portal for ankle arthroscopy. While there is a high risk of tendon injury in the medial midline portal.
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