Posterior Ankle and Hindfoot Arthroscopy.

Abstract

Posterior ankle and hindfoot arthroscopy, performed with use of posteromedial and posterolateral portals with the patient in the prone position, has become an important diagnostic and therapeutic procedure for various intra-articular and extra-articular disorders. If you are planning to use fluoroscopy for surgery and wire distraction, position the patient prone, flex the contralateral knee, and wrap the contralateral leg to a padded holder. Invasive distraction is used primarily to improve access to the ankle and subtalar joints. Using a mini-c-arm fluoroscopy unit to guide portal placement, place the posterolateral and posteromedial portals just lateral and medial to the Achilles tendon. Specific procedures include posterior arthroscopic arthrodesis of the subtalar joint, ankle arthrodesis, and excision of the os trigonum with tenolysis of the flexor hallucis longus tendon. Close the skin incision with nonabsorbable nylon sutures, and apply a sterile bulky dressing. Postoperatively, a plaster splint or walking boot with the foot in neutral is used for the first five to seven days. Posterior ankle and hindfoot arthroscopy was performed in 189 ankles (186 consecutive patients with a mean age of 37.1 years). IndicationsContraindicationsPitfalls & Challenges.