Surgical access to pathology of the talar dome (e.g., osteochondral lesions of the talus) can be limited because of the ankle joint congruity. When considering arthroscopic treatment, anterior arthroscopy with the ankle in plantar flexion or posterior arthroscopy with the ankle in dorsiflexion is used. The surgeon should carefully assess different clinical and radiologic aspects to plan the optimal operative approach. Meticulous physical examination, including ankle range of motion and possible palpation of a talar lesion, in combination with exact lesion localization on computed tomography or magnetic resonance imaging usually provide sufficient preoperative information. Most lesions with the anterior border localized on or anterior to the midline of the talus are accessible by anterior arthroscopy. In the case of preoperative doubt concerning the intraoperative accessibility, a computed tomography scan of the ankle in full plantarflexion is used to mirror arthroscopic reachability. Intraoperative surgical tricks to increase accessibility to the lesion may consist of an adjunct soft-tissue distraction device, reduction of the distal tibial rim, and treating the lesion from anteriorly to posteriorly, thereby gaining further exposure to the lesion throughout the procedure.
机构:
Univ Utah, Dept Orthopaed, Salt Lake City, UT USA
Univ Utah, Dept Orthopaed, Orthopaed Res Lab, Salt Lake City, UT USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
Barg, Alexej
Saltzman, Charles L.
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Univ Utah, Dept Orthopaed, Salt Lake City, UT USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
Saltzman, Charles L.
Beals, Timothy C.
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Univ Utah, Dept Orthopaed, Salt Lake City, UT USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
Beals, Timothy C.
Bachus, Kent N.
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Univ Utah, Dept Orthopaed, Orthopaed Res Lab, Salt Lake City, UT USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
Bachus, Kent N.
Blankenhorn, Brad D.
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Brown Univ, Warren Alpert Med Sch, Dept Orthopaed Surg, Providence, RI 02912 USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
Blankenhorn, Brad D.
Nickisch, Florian
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Univ Utah, Dept Orthopaed, Salt Lake City, UT USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
机构:
Univ Utah, Dept Orthopaed, Salt Lake City, UT USA
Univ Utah, Dept Orthopaed, Orthopaed Res Lab, Salt Lake City, UT USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
Barg, Alexej
Saltzman, Charles L.
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Univ Utah, Dept Orthopaed, Salt Lake City, UT USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
Saltzman, Charles L.
Beals, Timothy C.
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Univ Utah, Dept Orthopaed, Salt Lake City, UT USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
Beals, Timothy C.
Bachus, Kent N.
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Univ Utah, Dept Orthopaed, Orthopaed Res Lab, Salt Lake City, UT USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
Bachus, Kent N.
Blankenhorn, Brad D.
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Brown Univ, Warren Alpert Med Sch, Dept Orthopaed Surg, Providence, RI 02912 USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA
Blankenhorn, Brad D.
Nickisch, Florian
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Univ Utah, Dept Orthopaed, Salt Lake City, UT USAUniv Utah, Dept Orthopaed, Salt Lake City, UT USA