Accessibility of the Talar Dome-Anatomic Comparison of Plantarflexion Versus Noninvasive Distraction in Arthroscopy

Purpose: The purpose of this study was to evaluate the difference in accessibility of the talar dome during ankle arthroscopy between noninvasive distraction and maximum plantar flexion without distraction. Methods: For this study, 20 matched pairs (n = 40) of anatomic ankle specimens were used. Two groups (distraction or maximum plantar flexion) were defined. Through the use of chondral picks, the accessibility of each technique was tested arthroscopically. Afterward, the ankle joint was dissected and the reach achieved was measured and compared between the 2 groups. Results: Through noninvasive distraction, 13.1 +/- 4.4 mm of the talar dome was reached laterally and 16.7 +/- 3.7 mm medially. Through plantar flexion, 18.1 +/- 3.4 mm of the talar dome was reached laterally and 18.1 +/- 3.4 mm medially. Statistical comparison revealed a significantly better reach in plantar flexion on the lateral side of the talar dome (P = .007). There was no significant difference medially. Conclusions: Plantar flexion significantly improves reachability of the dome on the lateral side and it is equal to noninvasive distraction medially. Results of this study may allow for better access to the lesion of the talus.