Increasing the safety of minimally invasive hallux surgery: an anatomical study introducing the clock method

Background: the purpose of this study is to describe a simple and reproducible method to localize the neurological structures at risk and to describe a safe zone for hallux minimally invasive surgery (MIS) procedures. Methods: ten fresh-frozen cadaveric feet were dissected to identify the dorsomedia...

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Detalles Bibliográficos
Autores: Malagelada, Francesc, Dalmau-Pastor, Miki, Fargues Polo, Betlem, Manzanares Céspedes, María Cristina, Peña, Fernando, Vega, Jordi
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2018
País:España
Institución: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:2445/126076
Acceso en línea:https://hdl.handle.net/2445/126076
Access Level:acceso abierto
Palabra clave:Malformacions del peu
Malalties del peu
Cirurgia ortopèdica
Cirurgia operatòria
Artroscòpia
Peu
Foot abnormalities
Foot diseases
Orthopedic surgery
Operative surgery
Arthroscopy
Foot
Descripción
Sumario:Background: the purpose of this study is to describe a simple and reproducible method to localize the neurological structures at risk and to describe a safe zone for hallux minimally invasive surgery (MIS) procedures. Methods: ten fresh-frozen cadaveric feet were dissected to identify the dorsomedial digital nerve (DMDN) and the dorsolateral digital nerve (DLDN) of the first toe. Axial sections were performed at the sites of metatarsal osteotomies. We documented the position of the nerves with respect to the extensor hallucis longus (EHL) tendon using a clock method superimposed on the axial section. Results: the DMDN was found at an average of 26.2° medial to the medial border of the EHL tendon. (SD 11.26, range 14.5-45.5), whereas the average distance of the DLDN was 32.3° lateral to the medial border of the EHL tendon. (SD 6.29, range 13.5-40). Conclusions: using the clock method the DMDN and DLDN were found consistently between 10 o'clock and 2 o'clock in either right and left feet. The clock method may facilitate avoiding the area where these nerves are located serving as a valuable tool in minimally invasive foot surgery.