A comparison of surgical exposures for posterolateral osteochondral lesions of the talar dome

Alistair I. W. Mayne, Robert Lawton, Michael J. Reidy, Fraser Harrold, George Chami

    Research output: Contribution to journalArticle

    Abstract

    Background: Perpendicular access to the posterolateral talar dome for the management of osteochondral defects is difficult. We examined exposure available from each of four surgical approaches.

    Materials and methods: Four surgical approaches were performed on 9 Thiel-embalmed cadavers: anterolateral approach with arthrotomy; anterolateral approach with anterior talo-fibular ligament (ATFL) release; anterolateral approach with antero-lateral tibial osteotomy; and anterolateral approach with lateral malleolus osteotomy. The furthest distance posteriorly allowing perpendicular access with a 2 mm k-wire was measured.

    Results: An anterolateral approach with arthrotomy provided a mean exposure of the anterior third of the lateral talar dome. A lateral malleolus osteotomy provided superior exposure (81.5% vs 58.8%) compared to an anterolateral tibial osteotomy.

    Conclusions: Only the anterior half of the lateral border of the talar dome could be accessed with an anterolateral approach without osteotomy. A fibular osteotomy provided best exposure to the posterolateral aspect of the talar dome.

    LanguageEnglish
    Pages107-109
    Number of pages3
    JournalFoot and Ankle Surgery
    Volume24
    Issue number2
    Early online date13 Dec 2016
    DOIs
    Publication statusPublished - 1 Apr 2018

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    Osteotomy
    Cadaver
    Ligaments

    Keywords

    • Osteochondral defect
    • Osteochondral lesion
    • Surgical approach
    • Talus

    Cite this

    Mayne, Alistair I. W. ; Lawton, Robert ; Reidy, Michael J. ; Harrold, Fraser ; Chami, George. / A comparison of surgical exposures for posterolateral osteochondral lesions of the talar dome. In: Foot and Ankle Surgery. 2018 ; Vol. 24, No. 2. pp. 107-109.
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    abstract = "Background: Perpendicular access to the posterolateral talar dome for the management of osteochondral defects is difficult. We examined exposure available from each of four surgical approaches.Materials and methods: Four surgical approaches were performed on 9 Thiel-embalmed cadavers: anterolateral approach with arthrotomy; anterolateral approach with anterior talo-fibular ligament (ATFL) release; anterolateral approach with antero-lateral tibial osteotomy; and anterolateral approach with lateral malleolus osteotomy. The furthest distance posteriorly allowing perpendicular access with a 2 mm k-wire was measured.Results: An anterolateral approach with arthrotomy provided a mean exposure of the anterior third of the lateral talar dome. A lateral malleolus osteotomy provided superior exposure (81.5{\%} vs 58.8{\%}) compared to an anterolateral tibial osteotomy.Conclusions: Only the anterior half of the lateral border of the talar dome could be accessed with an anterolateral approach without osteotomy. A fibular osteotomy provided best exposure to the posterolateral aspect of the talar dome.",
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    A comparison of surgical exposures for posterolateral osteochondral lesions of the talar dome. / Mayne, Alistair I. W.; Lawton, Robert; Reidy, Michael J.; Harrold, Fraser; Chami, George.

    In: Foot and Ankle Surgery, Vol. 24, No. 2, 01.04.2018, p. 107-109.

    Research output: Contribution to journalArticle

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    AU - Lawton, Robert

    AU - Reidy, Michael J.

    AU - Harrold, Fraser

    AU - Chami, George

    PY - 2018/4/1

    Y1 - 2018/4/1

    N2 - Background: Perpendicular access to the posterolateral talar dome for the management of osteochondral defects is difficult. We examined exposure available from each of four surgical approaches.Materials and methods: Four surgical approaches were performed on 9 Thiel-embalmed cadavers: anterolateral approach with arthrotomy; anterolateral approach with anterior talo-fibular ligament (ATFL) release; anterolateral approach with antero-lateral tibial osteotomy; and anterolateral approach with lateral malleolus osteotomy. The furthest distance posteriorly allowing perpendicular access with a 2 mm k-wire was measured.Results: An anterolateral approach with arthrotomy provided a mean exposure of the anterior third of the lateral talar dome. A lateral malleolus osteotomy provided superior exposure (81.5% vs 58.8%) compared to an anterolateral tibial osteotomy.Conclusions: Only the anterior half of the lateral border of the talar dome could be accessed with an anterolateral approach without osteotomy. A fibular osteotomy provided best exposure to the posterolateral aspect of the talar dome.

    AB - Background: Perpendicular access to the posterolateral talar dome for the management of osteochondral defects is difficult. We examined exposure available from each of four surgical approaches.Materials and methods: Four surgical approaches were performed on 9 Thiel-embalmed cadavers: anterolateral approach with arthrotomy; anterolateral approach with anterior talo-fibular ligament (ATFL) release; anterolateral approach with antero-lateral tibial osteotomy; and anterolateral approach with lateral malleolus osteotomy. The furthest distance posteriorly allowing perpendicular access with a 2 mm k-wire was measured.Results: An anterolateral approach with arthrotomy provided a mean exposure of the anterior third of the lateral talar dome. A lateral malleolus osteotomy provided superior exposure (81.5% vs 58.8%) compared to an anterolateral tibial osteotomy.Conclusions: Only the anterior half of the lateral border of the talar dome could be accessed with an anterolateral approach without osteotomy. A fibular osteotomy provided best exposure to the posterolateral aspect of the talar dome.

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