Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Dec;25(4):831-836.
doi: 10.1007/s40477-021-00611-w. Epub 2022 Mar 16.

Anterior Ankle Arthroscopy: Advantage of a Preoperative Ultrasound Mapping to Prevent Neurovascular Complications

Marcello Lughi  1 , Mauro Cevolani  2 , Gabriele Testi  2 , Emanuele Piraccini  3 , Francesco Lijoi  4
Affiliations
Review

Anterior Ankle Arthroscopy: Advantage of a Preoperative Ultrasound Mapping to Prevent Neurovascular Complications

Marcello Lughi et al. J Ultrasound. 2022 Dec.

Abstract

Purpose: The aim of this study is to verify the usefulness of ultrasound-assisted mapping of the vascular and neurological structures in the anterior compartment of the ankle just before an anterior arthroscopic procedure to reduce these kinds of complications.

Methods: Various complications can be present in anterior arthroscopy of the ankle. The structures most prone to iatrogenic damage are vessels and nerves. They are macroscopically visible and palpable in a little more than 50% of cases, but arterial ramifications are not visible because they are located deeper.

Results: The authors have investigated how to reduce potential iatrogenic damage to the complex and variable neuro-vascular network of the anterior aspect of the ankle. They have completed the classic routine marking of the bony and tendinous structures with an ultrasound mapping of the neurovascular structures.

Conclusions: The authors concluded that ultrasound-assisted mapping is a non-invasive, fast, and safe procedure that can help to reduce potential iatrogenic damage when performing anterior arthroscopic surgery.

Keywords: Ankle; Arthroscopy; Complications; Pseudoaneurysm; Skin markers; Ultrasound.

PubMed Disclaimer

Conflict of interest statement

All the Authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
a “Thin foot”. b “Fat foot”. No evidence of the IDCN with inversion of the ankle, plantarflexion of the foot and flexion of the fourth toe
Fig. 2
Fig. 2
Question marks. Where IDCN will be proximal, near and distal to the distal line and antero-lateral portal (red circle)
Fig. 3
Fig. 3
Ultrasound mapping of the IDCN (yellow arrow) and of the artery (red arrow). Proximal to the joint line (a, b) at the joint line level (c, d), distal to the joint line (e, f)
Fig. 4
Fig. 4
Final IDCN map
Fig. 5
Fig. 5
a Vascular structures in the antero-lateral aspect of the ankle. b Echo-colour-Doppler exam
See this image and copyright information in PMC

References

    1. Karia PA, et al. Ankle position affects dorsalis pedis artery exposure in anterior ankle arthroscopy. Foot Ankle Surg. 2014;20:67–70. doi: 10.1016/j.fas.2013.11.004. - DOI - PubMed
    1. Zengerink M, Van Dijk CN. Complications in ankle arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2012;20:1420–1431. doi: 10.1007/s00167-012-2063-x. - DOI - PMC - PubMed
    1. Deng DF, Hamilton GA, Lee M, Rush S, Ford LA, Patel S. Complications associated with foot and ankle arthroscopy. J Foot Ankle Surg. 2012;51(3):281–284. doi: 10.1053/j.jfas.2011.11.011. - DOI - PubMed
    1. Ferkel RD. Complications in ankle and foot surgery. In: Whipple TL, editor. Arthroscopic surgery. The foot and ankle. Philadelphia: Lippincott-Raven; 1996. pp. 291–305.
    1. Barber FA, et al. Complications of ankle arthroscopy. Foot Ankle Int. 1990;10(5):263–266. doi: 10.1177/107110079001000504. - DOI - PubMed

LinkOut - more resources