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














  • Operative treatment of Freiberg disease using extra-articular dorsal closing-wedge osteotomy: technical tip and clinical outcomes in 13 patients.

    abstract:BACKGROUND:Extra-articular dorsal closing wedge osteotomy has been used with successful results for Freiberg disease; however, there has been concern regarding the technical difficulty. The purpose of this study was to address technical tips and report on the clinical and radiographic outcome using Kirchner wire-assist...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Lee HJ,Kim JW,Min WK

    更新日期:2013-01-01 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

  • Ankle block implemented through two skin punctures.

    abstract:BACKGROUND:Recently, peripheral nerve blocks have increasingly been used in orthopedic surgery. The foot block is an alternative for anesthesia in cases of forefoot and midfoot operations. We propose a modification of the block technique due to potential difficulties concerning the tibial nerve. MATERIALS AND METHODS:...

    journal_title:Foot & ankle international

    pub_type: 临床试验,杂志文章


    authors: Hromádka R,Barták V,Popelka S,Pokorný D,Jahoda D,Sosna A

    更新日期:2010-07-01 00:00:00

  • Relationship between tightness of the posterior muscles of the lower limb and plantar fasciitis.

    abstract:BACKGROUND:The aim of this study was to determine whether tightness of the posterior muscles of the lower extremity was associated with plantar fasciitis. METHODS:A total of 100 lower limbs of 100 subjects, 50 with plantar fasciitis and 50 matching controls were recruited. Hamstring and calf muscles were evaluated thr...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Bolívar YA,Munuera PV,Padillo JP

    更新日期:2013-01-01 00:00:00

  • The Distribution of the Superficial Peroneal Nerve on the Dorsum of the Foot and its Clinical Importance in Flap Surgery.

    abstract:BACKGROUND:The superficial peroneal nerve (SPN) and its branches are at risk during surgical exposures. Our study aimed to demonstrate the distribution of the SPN on the dorsum of the foot to aid in surgical procedures close to this nerve. METHODS:The SPN was dissected in 30 cadaver lower limbs (13 male and two female...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Ikiz ZAA,Ucerler H

    更新日期:2006-06-01 00:00:00

  • Defining flatfoot.

    abstract::Pes planus is a term frequently used in describing flatfoot; however, no study has objectively defined flatfoot. We evaluated the single leg stance footprint of 40 feet in 21 people with no history of foot problems, using pressure-sensitive film and a Harris mat. The medial and lateral aspects of the forefoot, midfoot...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Tareco JM,Miller NH,MacWilliams BA,Michelson JD

    更新日期:1999-07-01 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

  • Suture-button versus screw fixation in a syndesmosis rupture model: a biomechanical comparison.

    abstract:BACKGROUND:Flexible suture-button devices are used to stabilize the distal tibiofibular joint after syndesmotic rupture, but little is known about how they affect fibular motion during cyclic physiological loading. This study examined how much fibular motion occurs during cyclic loading of ankles repaired with suture-b...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Soin SP,Knight TA,Dinah AF,Mears SC,Swierstra BA,Belkoff SM

    更新日期:2009-04-01 00:00:00

  • Angioleiomyoma: clinical presentation and surgical management.

    abstract::Angioleiomyomas are relatively rare, benign, vascular soft tissue tumors with a predilection for the lower extremity. They may occur in either the cutaneous or subcutaneous tissue and are usually well encapsulated. Erosion of adjacent bone due to secondary compression phenomenon has rarely been reported in the literat...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Yates BJ

    更新日期:2001-08-01 00:00:00

  • Patients at Risk for Exceeding CJR Cost Targets After Total Ankle Arthroplasty.

    abstract:BACKGROUND:The Comprehensive Care for Joint Replacement (CJR) model includes total ankle arthroplasty (TAA), under which a target reimbursement is established. Whether this reimbursement is sufficient to cover average cost remains unknown. We hypothesized that a substantial number of TAAs still exceed cost targets, and...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Goltz DE,Ryan SP,Howell CB,Bolognesi MP,Seyler TM,Adams SB

    更新日期:2019-09-01 00:00:00

  • The Effect of Obesity on Functional Outcomes and Complications in Total Ankle Arthroplasty.

    abstract:BACKGROUND:The prevalence of obesity in the United States is staggering. Currently, the effect of obesity on third-generation total ankle replacement (TAR) is unknown. METHODS:We prospectively identified a consecutive series of 455 primary TARs operated between May 2007 and September 2013 who had a minimum follow-up o...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Gross CE,Lampley A,Green CL,DeOrio JK,Easley M,Adams S,Nunley JA 2nd

    更新日期:2016-02-01 00:00:00

  • Mid-substance peroneal tendon defects augmented with an acellular dermal matrix allograft.

    abstract:BACKGROUND:This study evaluated an acellular dermal matrix allograft augmentation for chronic mid-substance peroneous longus and brevis tendon tears. The hypothesis was that acellular dermal matrix allograft augmentation of chronic longitudinal mid-substance or complete tears of both peroneal tendons provides sufficien...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Rapley JH,Crates J,Barber A

    更新日期:2010-02-01 00:00:00

  • Endoscopic Flexor Hallucis Longus Transfer for Chronic Noninsertional Achilles Tendon Rupture.

    abstract:BACKGROUND::Operative management of chronic Achilles tendon ruptures is challenging, and numerous techniques have been described. Risk of infection and wound breakdown have been described after open techniques, and minimally invasive methods have been proposed to avoid them. The aim of this study was to describe the cl...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Vega J,Vilá J,Batista J,Malagelada F,Dalmau-Pastor M

    更新日期:2018-12-01 00:00:00

  • Radiographic Morphologic Characteristics of Bunionette Deformity.

    abstract:BACKGROUND:Bunionette deformity is characterized as head hypertrophy, lateral bowing, or splaying of the fifth metatarsal, or a combination of these deformities. Most previous studies have focused on the fourth and fifth metatarsals; few have analyzed the radiographic morphologic characteristics of the entire foot. The...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Shimobayashi M,Tanaka Y,Taniguchi A,Kurokawa H,Tomiwa K,Higashiyama I

    更新日期:2016-03-01 00:00:00

  • Influence of age, body mass index and leg dominance on functional ankle stability.

    abstract:BACKGROUND:The aim of this study was to examine the influence of age, body mass index (BMI) and leg dominance on the PRT, balance control and foot position sense. MATERIALS AND METHODS:The proprioception of the ankle was investigated in 210 participants. All participants completed a questionnaire. The PRT was measured...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Rein S,Fabian T,Zwipp H,Mittag-Bonsch M,Weindel S

    更新日期:2010-05-01 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

  • Distal anatomical relationship of the flexor hallucis longus and flexor digitorum longus tendons.

    abstract:BACKGROUND:The distal attachment of the flexor hallucis longus (FHL) tendon with the flexor digitorum longus (FDL) tendon varies antomically. The presence of a strong link between the two tendons can preserve distal function if one of the tendons is used for transfer. METHODS:Twenty-four cadaver legs were dissected, a...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: LaRue BG,Anctil EP

    更新日期:2006-07-01 00:00:00

  • Mechanical comparison of two types of fixation for proximal first metatarsal crescentic osteotomy.

    abstract:BACKGROUND:The proximal crescentic osteotomy is an effective technique for correcting a widened 1-2 intermetatarsal angle associated with moderate to severe hallux valgus deformities. However, postoperative dorsal malunion at the osteotomy site from loss of fixation has been reported. The purpose of this study was to e...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Jones C,Coughlin M,Petersen W,Herbot M,Paletta J

    更新日期:2005-05-01 00:00:00

  • Total ankle replacement in obese patients: component stability, weight change, and functional outcome in 118 consecutive patients.

    abstract:BACKGROUND:Obesity is a growing problem in Europe and the United States. While obesity has been linked to poor outcomes after total knee or hip replacement, there are no data addressing outcomes in obese patients who underwent total ankle replacement (TAR). METHODS:This retrospective chart review included 118 patients...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Barg A,Knupp M,Anderson AE,Hintermann B

    更新日期:2011-10-01 00:00:00

  • Bilateral ossification in the Achilles tendon: a case report.

    abstract::Bilateral symmetrical Achilles tendon ossification is presented, with a fracture on one side. A 57 year old male patient was conservatively treated for bilateral clubfeet in his childhood. Part of his Achilles tendons were replaced by ectopic bony mass and on the left it fractured without any trauma. The fracture was ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Mády F,Vajda A

    更新日期:2000-12-01 00:00:00

  • CT measurement of range of motion of ankle and subtalar joints following two lateral column lengthening procedures.

    abstract:BACKGROUND:Lateral column lengthening (LCL) has become an accepted procedure for the operative treatment of the flexible flatfoot deformity. Hindfoot arthrodesis via a calcaneocuboid distraction arthrodesis (CCDA) has been considered a less favourable surgical option than the anterior open wedge calcaneal distraction o...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Beimers L,Louwerens JW,Tuijthof GJ,Jonges R,van Dijk CN,Blankevoort L

    更新日期:2012-05-01 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

  • Functional evaluation of the Scandinavian Total Ankle Replacement.

    abstract::The purpose of this study was to evaluate the function of the ankle joint during walking before and after Scandinavian Total Ankle Replacement (STAR). Nine patients (six males and three females) with an average age of 65 years, scheduled for unilateral total ankle replacement for osteoarthritis and rheumatoid arthriti...

    journal_title:Foot & ankle international

    pub_type: 临床试验,杂志文章


    authors: Dyrby C,Chou LB,Andriacchi TP,Mann RA

    更新日期:2004-06-01 00:00:00

  • Staged treatment of high energy midfoot fracture dislocations.

    abstract:BACKGROUND:Staged care with interval external fixation is a successful established treatment strategy for high energy periarticular fractures with often extensive soft tissue damage such as the tibial plateau and plafond. The aim of the current study was to determine whether staged care of high energy midfoot fracture/...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Kadow TR,Siska PA,Evans AR,Sands SS,Tarkin IS

    更新日期:2014-12-01 00:00:00

  • Tarsal tunnel syndrome associated with an accessory muscle.

    abstract::Between 1986 and 1999, we surgically treated 41 patients (49 feet) with Tarsal Tunnel Syndrome (TTS) in whom seven (eight feet) were associated with an accessory muscle. An accessory flexor digitorum longus muscle was present in six patients, and an accessory soleus muscle was in one patient (both feet). Three of them...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Kinoshita M,Okuda R,Morikawa J,Abe M

    更新日期:2003-02-01 00:00:00

  • Isolated avulsion fracture at the plantar lateral base of the first metatarsal: a case report.

    abstract::We present a case of isolated avulsion fracture at the plantar lateral base of the first metatarsal without injuries of the tarsometatarsal joint. Few case reports can be found in the literature and it has been reported only as a part of the tarsometatarsal joint injuries. The basis for the diagnosis is discussed, as ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章,评审


    authors: Kwak HY,Bae SW

    更新日期:2000-10-01 00:00:00

  • Posterior tibial tendon tears in young competitive athletes: two case reports.

    abstract::Unlike the Achilles tendon, the posterior tibial tendon does not typically undergo acute rupture. We report two cases of posterior tibial tendon tears occurring in young, athletic individuals (<30 years old) that required operative intervention before the patients could return to competitive sports. We believe that th...

    journal_title:Foot & ankle international

    pub_type: 杂志文章,评审


    authors: Porter DA,Baxter DE,Clanton TO,Klootwyk TE

    更新日期:1998-09-01 00:00:00

  • Outcomes of a Stepcut Lengthening Calcaneal Osteotomy for Adult-Acquired Flatfoot Deformity.

    abstract:BACKGROUND:Lateral column lengthening is used to correct abduction deformity at the midfoot and improve talar head coverage in patients with flatfoot deformity. It was our hypothesis that following a stepcut lengthening calcaneal osteotomy (SLCO), patients would have adequate correction of the deformity, a high union r...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Demetracopoulos CA,Nair P,Malzberg A,Deland JT

    更新日期:2015-07-01 00:00:00

  • Prevalence of interdigital nerve enlargements in an asymptomatic population.

    abstract:BACKGROUND:Morton's neuroma is a common primary diagnosis for referral to foot and ankle surgeons. On presentation, many patients have had an ultrasound reporting the presence of Morton's neuroma, which may not correlate with the clinical examination findings. The prevalence of such sonographic findings in the general ...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Symeonidis PD,Iselin LD,Simmons N,Fowler S,Dracopoulos G,Stavrou P

    更新日期:2012-07-01 00:00:00

  • Piperacillin/tazobactam therapy for diabetic foot infection.

    abstract::In this study, 29 patients were hospitalized with a diabetic foot infection and were treated with piperacillin/tazobactam. Of these 23 patients who were evaluated for efficacy of treatment, 22 patients improved or were clinically cured. In seven patients (30%), there was persistence of one of the baseline pathogens. A...

    journal_title:Foot & ankle international

    pub_type: 杂志文章


    authors: Zeillemaker AM,Veldkamp KE,van Kraaij MG,Hoekstra JB,Hoynck van Papendrecht AA,Diepersloot RJ

    更新日期:1998-03-01 00:00:00