The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons
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Placement of a screw from the lateral wall of the calcaneus into the constant sustentaculum tali fragment can be difficult when surgically repairing a calcaneal fracture. This screw serves to compress the fracture fragments and support the posterior facet. This difficulty results from the small landing zone of the sustentaculum tali with its nearby vulnerable soft tissue structures. We present an anatomic study of 10 cadavers to determine a starting point and angle of screw advancement when placing a constant fragment screw.
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Ankle arthroscopic procedures offer less postoperative morbidity with faster healing times than open surgical procedures but still have associated risks. Complication rates as high as 17% have been reported. One of the most commonly reported complications is iatrogenic damage to the superficial peroneal nerve, which can result in numbness, tingling, or painful neuralgia. ⋯ Through our dissections, we found that most ankles have 2 nerve branches at the level of the ankle joint (Takao type II) and that the location of the superficial peroneal nerve branches at the ankle correlated directly with the ankle width. Additionally, 68% of specimens contained a nerve branch located in zone 1, where the anterolateral portal is placed, and 12% had a branch in zone 5, the location of the anteromedial portal site. The results of the present study have confirmed the wide variation in nerve location at the level of the ankle joint and serve to highlight the need for extreme caution during surgical procedures at the ankle.