Abstract:
BACKGROUND:Identifying the optimal starting point for intramedullary fixation of tibia and femur fractures is well described in the literature using a retrograde or anterograde technique. This technique has not been applied to the fifth metatarsal, where screw trajectory can cause iatrogenic malreduction. The generally accepted starting point for the fifth metatarsal is "high and inside" to accommodate the fifth metatarsal's dorsal apex and medial curvature. We used a retrograde technique to identify the optimal starting position for intramedullary fixation of fifth metatarsal fractures. METHODS:Five matched cadaveric lower extremity pairs were dissected to the fifth metatarsal neck. An osteotomy was made to access the intramedullary canal. A retrograde reamer was passed to the base of the fifth metatarsal to ascertain the ideal entry point. Distances from each major structure on the lateral aspect of the foot were measured. Computed tomography scans helped assess base edge measurements. RESULTS:In 6 of 10 specimens, the retrograde reamer hit the cuboid with a cuboid invasion averaging 0.7 mm. The peroneus brevis and longus were closest to the starting position with an average distance of 5.1 mm and 5.7 mm, respectively. Distances from the entry point to the dorsal, plantar, medial, and lateral edges of the metatarsal base were 8.3 mm, 6.9 mm, 9.7 mm, and 9.7 mm, respectively. CONCLUSION:Optimal starting position was found to be essentially at the center of the base of the fifth metatarsal at the lateral margin of the cartilage. Osteoplasty of the cuboid or forefoot adduction may be required to gain access to this site. CLINICAL RELEVANCE:This study evaluated the ideal starting position for screw placement of zone II base of the fifth metatarsal fractures, which should be considered when performing internal fixation for these fractures.
journal_name
Foot Ankle Intjournal_title
Foot & ankle internationalauthors
Watson GI,Karnovsky SC,Konin G,Drakos MCdoi
10.1177/1071100717702688subject
Has Abstractpub_date
2017-07-01 00:00:00pages
802-807issue
7eissn
1071-1007issn
1944-7876journal_volume
38pub_type
杂志文章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
doi:10.1177/107110070102200715
更新日期:2001-07-01 00:00:00
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journal_title:Foot & ankle international
pub_type: 杂志文章
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journal_title:Foot & ankle international
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journal_title:Foot & ankle international
pub_type: 杂志文章,随机对照试验
doi:10.1177/1071100713502179
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abstract::The purpose of this study was to evaluate the biomechanical properties of commonly used autogenous transplants for the surgical stabilization of chronic lateral ankle instability. We dissected the transplants (peroneus longus, peroneus brevis, Achilles and plantaris tendon, periosteal flap, fascia, corium) and the ant...
journal_title:Foot & ankle international
pub_type: 杂志文章
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abstract::Clinical and pedobarograph evaluation was performed on 16 patients following flexor hallucis longus (FHL) tendon transfers to determine the resulting morbidity due to the loss of FHL function. All patients underwent FHL tendon transfer for either chronic tendon Achilles rupture or chronic Achilles tendinosis. Clinical...
journal_title:Foot & ankle international
pub_type: 杂志文章
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abstract::The outcome of surgically treated mucous cysts of the foot is poorly documented in the orthopaedic literature. This study reports on the treatment of mucous cysts of the toes by simple excision and joint debridement. This is in contrast to treatment of similar lesions in the fingers which is often treated by excision ...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110070302400607
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abstract::A method for measuring first metatarsal rotation on weightbearing tangential radiographs is described. Under controlled conditions using cadaver specimens, 5 degree changes in first metatarsal rotation were associated with a mean change in radiographically measured rotation of 5.4 degrees (SD = 1.7 degrees). A clinica...
journal_title:Foot & ankle international
pub_type: 杂志文章
doi:10.1177/107110079601700307
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abstract::In an attempt to prevent migration of the heel pad, 11 patients underwent a combined Syme's amputation and Achilles tendon tenodesis between December 1989 and April 1992. Ten patients healed the Syme's amputation, and one patient failed to heal the surgical wounds and required a below-knee amputation. In all 10 succes...
journal_title:Foot & ankle international
pub_type: 临床试验,杂志文章
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journal_title:Foot & ankle international
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journal_title:Foot & ankle international
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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
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journal_title:Foot & ankle international
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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...
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Foot & ankle international
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更新日期:2020-11-01 00:00:00