Analysis of the soft tissue retraction pressures in total ankle arthroplasty: An in-vitro human cadaveric model

Total ankle arthroplasty wound healing complications are likely influenced by intraoperative retraction. The current study compared contact pressures from various retractors at multiple incision lengths in an anterior approach to the ankle. We hypothesized Gelpis created higher contact pressures and longer incisions reduced pressures.

Twelve cadaveric lower extremities were dissected using 12 cm, 15 cm and 20 cm incisions. A TekScan sensor measuring contact pressure and surface area was placed between the Gelpi, Army-Navy (short and long), and Weitlaner retractors and exposed soft tissue structures.

Average contact pressures reduced with increasing incision lengths except for Weitlaners. Army-Navy Long showed significantly lower pressures at 15 cm. Gelpis exhibited highest contact pressures except at 20 cm(p < 0.05). No significant differences were observed between retractors at 12 cm(p > 0.05).

Army-Navy retractors produced the least contact pressure in 12 cm and 15 cm incisions and self-retainers created higher contact pressures. Contact pressures typically decreased as incision lengths increased.

Level V.