Minimally Invasive Horizontal Intercartilaginous Incision during Tracheostomy – A Cadaveric Study

Background: Minimally invasive surgery for the treatment of hallux valgus deformities has become increasingly popular. Knowledge of the location of the hallux metatarsophalangeal (MTP) proximal capsular origin on the metatarsal neck is essential for surgeons in planning and executing extracapsular corrective osteotomies. A cadaveric study was undertaken to further study this anatomic relationship. Methods: Ten nonpaired fresh-frozen frozen cadaveric specimens were used for this study. Careful dissection was performed, and the capsular origin of the hallux MTP joint was measured from the central portion of the metatarsal head in the medial, lateral, dorsal, plantarmedial, and plantarlateral dimensions. Results: The ten specimens had a mean age of 77 years, with 5 female and 5 male. The mean distances from the central hallux metatarsal head to the MTP capsular origin were 15.2 mm dorsally, 8.4 mm medially, 9.6 mm laterally, 19.3 mm plantarmedially, and 21.0 mm plantarlaterally. Conclusion: The MTP capsular origin at the hallux metatarsal varies at different anatomic positions. Knowledge of this capsular anatomy is critical for orthopedic surgeons when planning and performing minimally invasive distal metatarsal osteotomies for the correction of hallux valgus. Type of Study: Cadaveric Study.

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Navigation-assisted fluoroscopy in minimally invasive direct lateral interbody fusion: a cadaveric study

SAS Journal ◽

10.1016/j.esas.2010.09.002 ◽

2010 ◽

Vol 4 (4) ◽

pp. 115-121 ◽

Cited By ~ 5

Author(s):

Jonathan E. Webb ◽

Gilad J. Regev ◽

Steven R. Garfin ◽

Choll W. Kim

Keyword(s):

Minimally Invasive ◽

Interbody Fusion ◽

Cadaveric Study ◽

Lateral Interbody Fusion ◽

Lateral Interbody

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Minimally Invasive Dorsal Cheilectomy of the First Metatarsal: A Cadaveric Study

Foot & Ankle International ◽

10.1177/1071100718791588 ◽

2018 ◽

Vol 39 (12) ◽

pp. 1497-1501 ◽

Cited By ~ 6

Author(s):

Kar Hao Teoh ◽

Esten Konstad Haanaes ◽

Saud Alshalawi ◽

Hiro Tanaka ◽

Kartik Hariharan

Keyword(s):

Minimally Invasive ◽

Average Distance ◽

Cadaveric Study ◽

Invasive Technique ◽

Optimal Position ◽

First Metatarsal ◽

Below The Knee ◽

Fresh Frozen ◽

Stab Incision ◽

Relationship Of

Background: Minimally invasive dorsal cheilectomy (MIDC) for hallus rigidus is gaining in popularity. The optimal position for the stab incision for MIDC is dorsomedial to allow an ergonomic sweeping movement of the burr, potentially putting the dorsomedial cutaneous nerve (DMCN) to the hallux at risk. We aimed to quantify the risk of using this minimally invasive technique with a cadaveric study. Methods: A total of 13 fresh-frozen cadaveric specimens amputated below the knee were obtained for this study. After the procedure, the specimens were dissected, and structures were inspected for damage. Results: The DMCN to the hallux was cut completely in 2 specimens (15%). All the extensor hallucis longus tendons were intact, although in 1 specimen, the tendon showed some fraying on the underside of the tendon. The average distance of the stab incision from the first metatarsophalangeal (MTP) joint was 17.7 (range, 10-23) mm. The relationship of the DMCN to the stab incision was variable. The average distance of the DMCN to the incision was 3.8 (range, 0-7) mm. The danger zone for damaging the DMCN was at one-third the length of the first metatarsal proximal to the first MTP joint. Conclusion: The DMCN has been well studied by several authors and has a variable course. This nerve was damaged in 15% of our specimens following MIDC. Clinical Relevance: We believe patients should be made aware of this risk when considering surgery. A carefully made working capsular pocket for the burr and marking this nerve before making the incision if palpable could mitigate this risk.

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