Journal article
The success rate of first metatarsophalangeal joint lateral soft tissue release through a medial transarticular approach: A cadaveric study
Foot and ankle surgery, Vol.25(6), pp.733-738
12/2019
DOI: 10.1016/j.fas.2018.09.006
PMID: 30385107
Abstract
•1st MTPJ lateral release can be accurately performed through a medial approach.•Chondral damage of the head of the 1st metatarsal should be avoided.•Unintended release of the conjoined and FHB tendons are frequent.
The objective of this study was to evaluate the success rate of first metatarsophalangeal joint (MTPJ) lateral soft tissue release through a medial transarticular approach.
Ten cadaveric specimens were used (6 females/4 males, mean age, 73.4years). Lateral release was performed through a 4cm medial approach using a number 15 blade. Surgical aim was to release four specific structures: lateral capsule, lateral collateral ligament (LCL), adductor hallucis tendon (AHT) and lateral metatarsosesamoid suspensory ligament (LMSL). Once completed, a dissection of the first intermetatarsal space was performed. Success rate was graded in accordance to the number of structures successfully released: 0% (no structures), 25% (1/4), 50% (2/4), 75% (3/4) and 100% (4/4). Inadvertent injuries to other soft tissue structures were recorded.
The success rate for lateral soft tissue release was 100% in 7 cadaveric specimens, and respectively 75%, 50% and 25% in the other 3 specimens. The LCL was successfully released in all specimens. The lateral joint capsule, AHT and LMSL were released in 80% of the specimens. Chondral damage to the first metatarsal head, unintended release of the conjoined tendon and lateral head of the flexor hallucis brevis (FHB) occurred respectively in 40%, 50% and 20% of the specimens.
Our cadaveric study demonstrated high success rate in the release of specific lateral soft tissue structures of the first MTPJ through a medial transarticular approach. Inadvertent release of the lateral head of the FHB, conjoined tendon and iatrogenic chondral damage of the first metatarsal head are complications to be considered.
Cadaveric study — Level V.
Details
- Title: Subtitle
- The success rate of first metatarsophalangeal joint lateral soft tissue release through a medial transarticular approach: A cadaveric study
- Creators
- Cesar de Cesar Netto - Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USALauren E Roberts - Department of Orthopaedics, Foot and Ankle, Hospital for Special Surgery, New York, NY, USAParke William Hudson - Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USABrent Cone - Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USABahman Sahranavard - Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USAIbukunoluwa Araoye - Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USAAshish Shah - Department of Orthopaedics, Foot and Ankle, Hospital for Special Surgery, New York, NY, USA
- Resource Type
- Journal article
- Publication Details
- Foot and ankle surgery, Vol.25(6), pp.733-738
- Publisher
- Elsevier Ltd
- DOI
- 10.1016/j.fas.2018.09.006
- PMID
- 30385107
- ISSN
- 1268-7731
- eISSN
- 1460-9584
- Language
- English
- Date published
- 12/2019
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040328602771
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