How to get to the distal posterior tibial malleolus? a cadaveric anatomic study defining the access corridors through 3 different approaches.

Objective: Our objective is to review the anatomy and exposure of the posterior column and posterior tibial malleolus (the posterior tibial plafond) by defining the access corridors through 3 different approaches-posteromedial, posterolateral, and modified posteromedial. Methods: Cadaveric dissectio...

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Detalhes bibliográficos
Autores: Assal, Mathieu, Dalmau-Pastor, Miki, Ray, Adrien, Stern, Richard
Formato: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2017
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/217536
Acesso em linha:https://hdl.handle.net/2445/217536
Access Level:acceso abierto
Palavra-chave:Fractures
Turmell
Cadàvers
Dissecció humana
Ankle
Cadavers
Human dissection
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spelling How to get to the distal posterior tibial malleolus? a cadaveric anatomic study defining the access corridors through 3 different approaches.Assal, MathieuDalmau-Pastor, MikiRay, AdrienStern, RichardFracturesTurmellCadàversDissecció humanaFracturesAnkleCadaversHuman dissectionObjective: Our objective is to review the anatomy and exposure of the posterior column and posterior tibial malleolus (the posterior tibial plafond) by defining the access corridors through 3 different approaches-posteromedial, posterolateral, and modified posteromedial. Methods: Cadaveric dissection with percentage of posterior tibial malleolus exposed, and strain gauge measurements to evaluate traction on the neurovascular bundle. Results: The 3 different approaches are applicable for exposure of different portions of the distal posterior tibial malleolus. Strain gauge measurements reveal the least traction on the flap containing the neurovascular bundle with the modified posteromedial approach (7.0 N) compared with the posteromedial (21.5 N) and posterolateral (16.8 N) approaches. Exposure of the posterior tibial malleolus was greater with the modified posteromedial approach (91%) compared with the other 2 approaches (posteromedial = 64%, posterolateral = 40%). Conclusions: Depending on the location of the principal fracture fragments, particularly in high energy ankle and pilon fractures, each of the posterior approaches has its indication, with the modified posteromedial approach revealing more of the posterior anatomy than the other 2 approaches. The latter approach places the least traction on the flap containing the neurovascular bundle.Lippincott, Williams & Wilkins. Wolters Kluwer Health2025202520172025info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersion6 p.application/pdfhttps://hdl.handle.net/2445/217536Articles publicats en revistes (Patologia i Terapèutica Experimental)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésVersió postprint del document publicat a: https://doi.org/10.1097/BOT.0000000000000774Journal of Orthopaedic Trauma, 2017, vol. 31, num.4, p. 127-129https://doi.org/10.1097/BOT.0000000000000774(c) Lippincott, Williams & Wilkins. Wolters Kluwer Health, 2017info:eu-repo/semantics/openAccessoai:recercat.cat:2445/2175362026-05-29T05:05:01Z
dc.title.none.fl_str_mv How to get to the distal posterior tibial malleolus? a cadaveric anatomic study defining the access corridors through 3 different approaches.
title How to get to the distal posterior tibial malleolus? a cadaveric anatomic study defining the access corridors through 3 different approaches.
spellingShingle How to get to the distal posterior tibial malleolus? a cadaveric anatomic study defining the access corridors through 3 different approaches.
Assal, Mathieu
Fractures
Turmell
Cadàvers
Dissecció humana
Fractures
Ankle
Cadavers
Human dissection
title_short How to get to the distal posterior tibial malleolus? a cadaveric anatomic study defining the access corridors through 3 different approaches.
title_full How to get to the distal posterior tibial malleolus? a cadaveric anatomic study defining the access corridors through 3 different approaches.
title_fullStr How to get to the distal posterior tibial malleolus? a cadaveric anatomic study defining the access corridors through 3 different approaches.
title_full_unstemmed How to get to the distal posterior tibial malleolus? a cadaveric anatomic study defining the access corridors through 3 different approaches.
title_sort How to get to the distal posterior tibial malleolus? a cadaveric anatomic study defining the access corridors through 3 different approaches.
dc.creator.none.fl_str_mv Assal, Mathieu
Dalmau-Pastor, Miki
Ray, Adrien
Stern, Richard
author Assal, Mathieu
author_facet Assal, Mathieu
Dalmau-Pastor, Miki
Ray, Adrien
Stern, Richard
author_role author
author2 Dalmau-Pastor, Miki
Ray, Adrien
Stern, Richard
author2_role author
author
author
dc.subject.none.fl_str_mv Fractures
Turmell
Cadàvers
Dissecció humana
Fractures
Ankle
Cadavers
Human dissection
topic Fractures
Turmell
Cadàvers
Dissecció humana
Fractures
Ankle
Cadavers
Human dissection
description Objective: Our objective is to review the anatomy and exposure of the posterior column and posterior tibial malleolus (the posterior tibial plafond) by defining the access corridors through 3 different approaches-posteromedial, posterolateral, and modified posteromedial. Methods: Cadaveric dissection with percentage of posterior tibial malleolus exposed, and strain gauge measurements to evaluate traction on the neurovascular bundle. Results: The 3 different approaches are applicable for exposure of different portions of the distal posterior tibial malleolus. Strain gauge measurements reveal the least traction on the flap containing the neurovascular bundle with the modified posteromedial approach (7.0 N) compared with the posteromedial (21.5 N) and posterolateral (16.8 N) approaches. Exposure of the posterior tibial malleolus was greater with the modified posteromedial approach (91%) compared with the other 2 approaches (posteromedial = 64%, posterolateral = 40%). Conclusions: Depending on the location of the principal fracture fragments, particularly in high energy ankle and pilon fractures, each of the posterior approaches has its indication, with the modified posteromedial approach revealing more of the posterior anatomy than the other 2 approaches. The latter approach places the least traction on the flap containing the neurovascular bundle.
publishDate 2017
dc.date.none.fl_str_mv 2017
2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/217536
url https://hdl.handle.net/2445/217536
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Versió postprint del document publicat a: https://doi.org/10.1097/BOT.0000000000000774
Journal of Orthopaedic Trauma, 2017, vol. 31, num.4, p. 127-129
https://doi.org/10.1097/BOT.0000000000000774
dc.rights.none.fl_str_mv (c) Lippincott, Williams & Wilkins. Wolters Kluwer Health, 2017
info:eu-repo/semantics/openAccess
rights_invalid_str_mv (c) Lippincott, Williams & Wilkins. Wolters Kluwer Health, 2017
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 6 p.
application/pdf
dc.publisher.none.fl_str_mv Lippincott, Williams & Wilkins. Wolters Kluwer Health
publisher.none.fl_str_mv Lippincott, Williams & Wilkins. Wolters Kluwer Health
dc.source.none.fl_str_mv Articles publicats en revistes (Patologia i Terapèutica Experimental)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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