Jesús Más Martínez, M. D. , Carmen Verdú Román, M. D

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Presentation transcript:

Arthroscopic Treatment of a Malunion of a Posteromedial Tubercle Fracture of the Talus Jesús Más Martínez, M.D., Carmen Verdú Román, M.D., Enrique Martínez Giménez, M.D., Javier Sanz-Reig, M.D., David Bustamante Suárez de Puga, M.D., Manuel Morales Santías, M.D. Arthroscopy Techniques Volume 6, Issue 6, Pages e2107-e2110 (December 2017) DOI: 10.1016/j.eats.2017.08.020 Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 1 Preoperative anteroposterior and lateral radiographs of a right ankle showing a posteromedial talus fracture (arrow). Arthroscopy Techniques 2017 6, e2107-e2110DOI: (10.1016/j.eats.2017.08.020) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 2 Preoperative 3-dimensional right ankle reconstruction showing a displaced posteromedial talus fracture with malunion (arrow). Arthroscopy Techniques 2017 6, e2107-e2110DOI: (10.1016/j.eats.2017.08.020) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 3 The patient is in the prone position. Portal placement is shown for the right ankle. Placement of the posterolateral portal is performed just lateral to the Achilles tendon at the level of the tip of the malleolus. A 4-mm 30° arthroscope is in position. The posteromedial portal is made just medial to the Achilles tendon, at the same level as the posterolateral portal. A shaver is introduced and directed toward the arthroscope shaft. Arthroscopy Techniques 2017 6, e2107-e2110DOI: (10.1016/j.eats.2017.08.020) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 4 Arthroscopic view of the posteromedial aspect of the right ankle from the posterolateral portal. The fracture malunion (yellow arrow) and posterior ankle impingement are visualized. A shaver is introduced through the posteromedial portal. The flexor hallucis longus is on the medial side with a base loop around it (green arrow). Arthroscopy Techniques 2017 6, e2107-e2110DOI: (10.1016/j.eats.2017.08.020) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 5 Arthroscopic view of the posteromedial aspect of the right ankle from the posterolateral portal. Partial resection of the fracture malunion (arrow) is performed. A burr is introduced through the posteromedial portal. Arthroscopy Techniques 2017 6, e2107-e2110DOI: (10.1016/j.eats.2017.08.020) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 6 Arthroscopic view of the posteromedial aspect of the right ankle from the posterolateral portal. Final reshaping of the posterior talus is performed, and posterior ankle impingement (red arrow) is corrected. The flexor hallucis longus is on the medial side with a base loop around it (green arrow). Arthroscopy Techniques 2017 6, e2107-e2110DOI: (10.1016/j.eats.2017.08.020) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions

Fig 7 Three-dimensional reconstruction 1 month after arthroscopic resection of a malunion of a posteromedial talus fracture showing correction of posterior ankle impingement (arrow). Arthroscopy Techniques 2017 6, e2107-e2110DOI: (10.1016/j.eats.2017.08.020) Copyright © 2017 Arthroscopy Association of North America Terms and Conditions