Safe Zone for the Plantar Portal: A Cadaveric Study.


BACKGROUND:Understanding the plantar nerve anatomy is crucial for safe endoscopic surgery of the sole. We aimed to anatomically dissect the lateral aspect and soles of cadaveric feet to investigate the safety of peroneus longus tendoscopy with a plantar lateral portal and the safe zones for plantar portals. METHODS:We studied 36 feet of 24 cadavers (mean age, 86.5 years). A cannula for 2.7-mm scope was inserted from the plantar lateral portal to the peroneus longus tendon, and the positional relationship between the cannula and sural nerve was observed. Then, the soft tissue of the sole was dissected, and the relationships between the plantar nerve and flexor digitorum longus tendon and flexor hallucis longus tendon was observed. The plantar nerve course was digitally imaged and uploaded into Image J software to determine nerve position. We further observed the positional relationship between the cannula and plantar nerve. RESULT:The mean minimum distance between the cannula and sural nerve was 13.8 mm, and the closest distance was 4.2 mm, allowing for the relatively safe creation of a plantar lateral portal. The use of the plantar lateral portal and evaluation of the peroneal tendon was safe with respect to the lateral plantar nerve as the nerve was in a different tissue layer of the foot. Dissection of the plantar foot demonstrated a relatively safe zone, 36.4% to 56% along a line between the medial aspect of the base of the first metatarsal bone to the proximal tip of the fifth metatarsal. This region may allow for a plantar endoscopic portal; however an anatomic variation may result in the plantar nerve being within this zone. The flexor digitorum longus tendon and peroneus longus tendon passed through the deep layer of the relatively safe zone. CONCLUSION:Peroneus longus tendoscopy was relatively safe to perform from a plantar lateral portal. No neurovascular structure exists on the slightly medial aspect of the central region of the sole, potentially allowing for a relatively safe creation of plantar central portal. An approach from the plantar central portal to the flexor digitorum longus tendon, flexor hallucis longus tendon, and peroneus longus tendon allows for a greater range of vision and treatment options as compared with conventional approaches. The combination of the plantar central portal with portals such as the plantar lateral portal may further the development of endoscopic surgery of the sole. CLINICAL RELEVANCE:We found the anatomic characteristics of a relatively safe zone for the plantar portal for plantar lateral portal.


Foot Ankle Int


Maeda S,Niki H,Hirano T,Akiyama Y




Has Abstract


2016-02-01 00:00:00














  • Outcome study of hallux valgus surgery--an AOFAS multi-center study.

    abstract::Three hundred and eleven patients have been enrolled in a multi-center prospective study evaluating the outcome of hallux valgus surgery by the members of the American Orthopaedic Foot and Ankle Society. One hundred seventy-nine of these patients have completed six-month follow-up questionnaires, and 195 have complete...

    journal_title:Foot & ankle international

    pub_type: 杂志文章,多中心研究


    authors: Thordarson DB,Rudicel SA,Ebramzadeh E,Gill LH

    更新日期:2001-12-01 00:00:00

  • The arch index: a measure of flat or fat feet?

    abstract:BACKGROUND:Studies using footprint-based estimates of arch height have indicated that obesity results in a lowered medial longitudinal arch in children. However, the potentially confounding effect of body composition on indirect measures of arch height, such as the arch index, has not been investigated. METHODS:This s...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Wearing SC,Hills AP,Byrne NM,Hennig EM,McDonald M

    更新日期:2004-08-01 00:00:00

  • Benign calcaneal bone cyst and pathologic fracture--surgical treatment with injectable calcium-phosphate bone cement (Norian): a case report.

    abstract::Solitary calcaneal bone cysts are uncommon. Usually they measure 1/3 to 1/2 of the calcaneal length. Symptomatic calcaneal bone cysts are generally treated with open debridement and autologous bone grafting. We report a case of a patient with a displaced intra-articular calcaneal fracture who presents with a large ben...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Csizy M,Buckley RE,Fennell C

    更新日期:2001-06-01 00:00:00

  • Reliability of F-scan in-shoe measurements of plantar pressure.

    abstract::Research by our group and others indicates that many amputations of the lower limb occur after foot ulceration in patients with diabetes. It has been proposed that diabetic foot ulcers are mainly caused by repetitive trauma in areas of high plantar pressure during walking. Recent technology permits in-shoe measurement...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Ahroni JH,Boyko EJ,Forsberg R

    更新日期:1998-10-01 00:00:00

  • Tibiofibular synostosis stress fracture: a case report.

    abstract::A case of tibiofibular synostosis stress fracture is reported with its clinical and radiographic appearance as well as treatment. ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Horst F,Nunley JA

    更新日期:2004-07-01 00:00:00

  • Postoperative range of motion trends following total ankle arthroplasty.

    abstract:BACKGROUND:It is still unknown how ankle range of motion changes following total ankle arthroplasty. This study was undertaken to more accurately address patient expectations, guide postoperative rehabilitation, and improve our understanding of how ankle range of motion changes with time. METHODS:119 total ankle repla...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Ajis A,Henriquez H,Myerson M

    更新日期:2013-05-01 00:00:00

  • Outcome of Joint-Preserving Arthroplasty for Rheumatoid Forefoot Deformities.

    abstract:BACKGROUND:Along with the recent advances in the pharmacological management of rheumatoid arthritis, there is a trend toward the use of joint-preserving surgery in the treatment of rheumatoid forefoot deformities. However, the clinical outcomes of joint-preserving surgery for rheumatoid forefoot deformities have not be...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Fukushi J,Nakashima Y,Okazaki K,Yamada H,Mawatari T,Ohishi M,Oyamada A,Akasaki Y,Iwamoto Y

    更新日期:2016-03-01 00:00:00

  • Ipsilateral peroneus brevis tendon grafting in a complicated case of traumatic rupture of tibialis anterior tendon.

    abstract::Ruptures of tibialis anterior tendon can be caused by open, closed, direct, or indirect trauma, as well as spontaneously. Sixty-three cases of tibialis anterior tendon ruptures have been reported in the international literature. The treatment of choice is the surgical end-to-end or side-to-side anastomosis after previ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章,评审


    authors: Forst R,Forst J,Heller KD

    更新日期:1995-07-01 00:00:00

  • Long-term results of Mitchell's procedure for hallux valgus deformity: a 5- to 20-year followup in 204 cases.

    abstract:BACKGROUND:There are limited studies on the long term outcome of Mitchell's osteotomy for hallux valgus deformity. We present the long term results of 204 cases. MATERIALS AND METHODS:Postoperative clinical and radiological evaluation with a mean follow up of 12.9 years was performed on patients with preoperative hall...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Dermon A,Tilkeridis C,Lyras D,Tryfonidis M,Petrou C,Tzanis S,Kazakos K,Petrou G

    更新日期:2009-01-01 00:00:00

  • Opinions on lesser toe deformities among Dutch orthopaedic departments.

    abstract:BACKGROUND:Wide variations in definitions of lesser toe deformities exist. In addition, a general consensus regarding treatment of lesser toe deformities is lacking. The objective of this study was to evaluate of the definitions, current concepts, and treatment protocols for lesser toe deformities among orthopaedic dep...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Schrier JC,Louwerens JW,Verheyen CC

    更新日期:2007-12-01 00:00:00

  • Clawtoe deformity following vascularized fibula graft.

    abstract::The free vascularized fibula graft has been an increasingly useful tool in orthopaedic surgery. In addition to its many applications, the reported low donor site morbidity has helped make this a popular treatment modality. Isolated flexor hallucis longus flexion contracture has been reported in the literature; however...

    journal_title:Foot & ankle international

    pub_type: 杂志文章,评审


    authors: Bohay DR,Manoli A 2nd

    更新日期:1995-10-01 00:00:00

  • Chronic subluxation of the midtarsal joint of the foot: a case report.

    abstract::Traumatic injuries to the midtarsal joint are quite uncommon and usually involve fractures of adjacent bones. Pure dislocations without fracture are very rare. A patient sustained a pure dislocation that was treated with a nonweight-bearing cast for six weeks, but she went on to present with chronic subluxation at the...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Milgram JW

    更新日期:2002-03-01 00:00:00

  • Partial Achilles tendon ruptures associated with fluoroquinolone antibiotics: a case report and literature review.

    abstract::Fluoroquinolone antibiotics (such as olprofloxacin, pefloxacin, ofloxacin, norfloxacin, temafloxacin, etc.) have recently been implicated in the etiology of Achilles tendinitis and subsequent tendon rupture. We report on a patient with bilateral partial Achilles tendon ruptures associated with ciprofloxacin therapy an...

    journal_title:Foot & ankle international

    pub_type: 杂志文章,评审


    authors: McGarvey WC,Singh D,Trevino SG

    更新日期:1996-08-01 00:00:00

  • Intermediate follow-up on the double osteotomy and tendon transfer procedure for stage II posterior tibial tendon insufficiency.

    abstract::26 patients with 28 pes planovalgus feet secondary to Johnson stage 2 posterior tibial tendon insufficiency were treated with flexor digitorum longus tendon transfer, lateral column lengthening, medial displacement calcaneal osteotomy, and heel cord lengthening. The mean patient age at surgery was 48.5 years. The AOFA...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Moseir-LaClair S,Pomeroy G,Manoli A 2nd

    更新日期:2001-04-01 00:00:00

  • Three-dimensional computer analysis of the modified Ludloff osteotomy.

    abstract:BACKGROUND:The Ludloff first metatarsal osteotomy is used to correct the increased 1-2 intermetatarsal angle associated with hallux valgus deformity. We studied the spatial geometry of this osteotomy to determine the ideal parameters of the osteotomy saw cut and its rotation to give an optimal correction. METHODS:Thre...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Beischer AD,Ammon P,Corniou A,Myerson M

    更新日期:2005-08-01 00:00:00

  • The "Giftbox" repair of the Achilles tendon: a modification of the Krackow technique.

    abstract:BACKGROUND:The Krackow locking loop technique has been used for Achilles tendon repair with documented success in allowing early range of motion with stable fixation. Previous studies documented failure at the rupture site by knot failure. We propose a modification of the traditional Krackow technique where the knots o...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Labib SA,Rolf R,Dacus R,Hutton WC

    更新日期:2009-05-01 00:00:00

  • Rearfoot-forefoot orientation and traumatic risk for runners.

    abstract::Factors making runners more susceptible to injuries were identified with a comparative study between a healthy control group (216) and runners (66) suffering from overuse pathology. On static and dynamic footprint, the angles alpha0 (static) and alpha1 (dynamic) between heel and forefoot have been measured. Analysis s...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Busseuil C,Freychat P,Guedj EB,Lacour JR

    更新日期:1998-01-01 00:00:00

  • Inverse Relationship Between Radiographic Lateral Ankle Instability and Osteochondral Lesions of the Talus in Patients With Ankle Inversion Injuries.

    abstract:BACKGROUND:Insufficient or excessive bony constraint surrounding the talus might contribute to the occurrence of ligamentous injury or bone contusion, respectively, at the time of ankle inversion injuries. This study aimed to investigate the relationship between radiographic lateral ankle instability and osteochondral ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Park BS,Chung CY,Park MS,Sung KH,Choi Y,Park C,Koo S,Lee KM

    更新日期:2019-12-01 00:00:00

  • Prospective CT scan evaluation of hindfoot nonunions treated with revision surgery and low-intensity ultrasound stimulation.

    abstract:BACKGROUND:The reported fusion rates of revision arthrodesis for hindfoot nonunions are relatively low compared to primary procedures. Exogenous ultrasound has been shown to accelerate the healing process of acute fractures and fracture nonunions but has not been previously evaluated for the treatment of hindfoot pseud...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Jones CP,Coughlin MJ,Shurnas PS

    更新日期:2006-04-01 00:00:00

  • Effect of foot and ankle position on tarsal tunnel compartment volume.

    abstract:BACKGROUND:Tarsal tunnel pressure is increased when the foot and ankle are positioned in eversion or inversion from neutral, aggravating symptoms of tarsal tunnel syndrome in some patients. Space-occupying lesions may cause tarsal tunnel syndrome. We hypothesized that positional change of the foot and ankle from neutra...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Bracilovic A,Nihal A,Houston VL,Beattie AC,Rosenberg ZS,Trepman E

    更新日期:2006-06-01 00:00:00

  • Long-term costs for foot ulcers in diabetic patients in a multidisciplinary setting.

    abstract::The purpose of this study was to analyze long-term costs for foot ulcers in diabetic patients. Patients were treated and followed prospectively by a foot care team. A retrospective economic analysis was performed of costs for 274 patients during 3 years from healing of an initial foot ulcer, with or without amputation...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Apelqvist J,Ragnarson-Tennvall G,Larsson J,Persson U

    更新日期:1995-07-01 00:00:00

  • The effect of subtalar joint position on dorsiflexion of the ankle/rearfoot versus midfoot/forefoot during gastrocnemius stretching.

    abstract:BACKGROUND:Limited ankle joint dorsiflexion passive range of motion (PROM) has been associated with common chronic lower extremity conditions, and clinicians often instruct patients in stretching exercises to increase dorsiflexion. However, little is known about how subtalar joint (STJ) position affects dorsiflexion at...

    journal_title:Foot & ankle international

    pub_type: 杂志文章,随机对照试验


    authors: Johanson MA,DeArment A,Hines K,Riley E,Martin M,Thomas J,Geist K

    更新日期:2014-01-01 00:00:00

  • Arthroscopic removal of an osteoid osteoma of the talus: a case report.

    abstract::This article describes a patient with a 10-year history of persistent ankle pain. Differential diagnosis included osteoid osteoma and anterior ankle impingement. This patient subsequently underwent arthroscopic excision of a lesion on the talar neck following a complete radiographic work-up, which was nondiagnostic. T...

    journal_title:Foot & ankle international

    pub_type: 杂志文章,评审


    authors: Resnick RB,Jarolem KL,Sheskier SC,Desai P,Cisa J

    更新日期:1995-04-01 00:00:00

  • Syme Amputation: A Systematic Review.

    abstract:BACKGROUND:In the decision-making process toward an amputation of the lower extremity, knowledge about patient-related outcomes after amputation and rehabilitation is important. We have not found a systematic review that provides this knowledge for Syme amputation. The aim of this study was to present an overview of ou...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Braaksma R,Dijkstra PU,Geertzen JHB

    更新日期:2018-03-01 00:00:00

  • Initial hospital-related cost comparison of total ankle replacement and ankle fusion with hip and knee joint replacement.

    abstract:BACKGROUND:Total hip and knee arthroplasty (THA and TKA) are accessible to patients with end-stage hip and knee arthritis in most health care systems. The availability of total ankle arthroplasty (TAA) to patients with end-stage ankle arthritis is often restricted because of prosthesis cost. Ankle fusion (AF) is often ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Younger AS,MacLean S,Daniels TR,Penner MJ,Wing KJ,Dunbar M,Glazebrook M

    更新日期:2015-03-01 00:00:00

  • Effect of Ankle Position on Tibiotalar Motion With Screw Fixation of the Distal Tibiofibular Syndesmosis in a Fracture Model.

    abstract:BACKGROUND:Anatomic reduction and fixation of the syndesmosis in traumatic injuries is paramount in restoring function of the tibiotalar joint. While overcompression is a potential error, recent work has called into question whether ankle position during fixation really matters in this regard. Our study aimed to corrob...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Pallis MP,Pressman DN,Heida K,Nicholson T,Ishikawa S

    更新日期:2018-06-01 00:00:00

  • Radiographic Change of the Distal Tibiofibular Joint Following Removal of Transfixing Screw Fixation.

    abstract:BACKGROUND:Syndesmosis disruptions in the ankle joint are typically treated with anatomic reduction followed by transfixing screw and/or suture button fixation. The purpose of our study was to analyze the effects of the removal of transfixing screws on syndesmosis integrity using plain radiographs and computed tomograp...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Baek JH,Kim TY,Kwon YB,Jeong BO

    更新日期:2018-03-01 00:00:00

  • Outcomes and Return to Activity After Operative Repair of Chronic Latent Syndesmotic Instability.

    abstract:BACKGROUND:This study is a retrospective review of prospectively gathered data determining the postoperative outcomes of patients who underwent operative treatment to address chronic syndesmotic instability. METHODS:The cohort is composed of 19 individuals who elected to undergo operative treatment of chronic syndesmo...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Ryan PM,Rodriguez RM

    更新日期:2016-02-01 00:00:00

  • Analysis of the Effect of Tibial Stem Length on Coronal Plane Deformity of the Tibial Component in Total Ankle Arthroplasty.

    abstract:BACKGROUND:Coronal plane deformity is common in patients who undergo total ankle arthroplasty. The correction of this deformity is paramount to the long-term survival of the implant. Coronal plane correction is achieved with soft tissue balancing and, in some part, is maintained through articular geometry constraint. T...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Berlet GC,Langan TM,Jamieson MD,Ferrucci AM

    更新日期:2019-10-01 00:00:00

  • Anterior dislocation of the subtalar joint: a case report.

    abstract::We report a very rare case of anterior dislocation of the subtalar joint. Forceful supination of the foot and dorsiflexion of the ankle was considered the cause of the injury in this case. Closed reduction was successful for the talocalcaneal component of subtalar joint, although surgery was subsequently performed bec...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Kanda T,Sakai H,Koseki K,Tamai K,Takeyama N,Saotome K

    更新日期:2001-07-01 00:00:00