ANATOMIC STUDY OF ARTHROSCOPIC PORTAL SITES OF THE ANKLE

Numerous anatomic structures are at risk when performing ankle arthros copy through the more commonly utilized portals. The purpose of this p aper was to demonstrate the relative safety of each of the arthroscopi c portal and Acufex external ankle distractor pin sites by measuring t heir proximity to the neurovascular structures surrounding the ankle j oint. Six fresh cadaver specimens and 12 fresh-frozen, below-knee ampu tations were utilized for this study. An Acufex ankle distractor was a pplied using the standard technique. Anteromedial, anterolateral, ante rocentral, posterolateral, and posteromedial portals were placed using an 11-blade scalpel to make 5-mm longitudinal incisions. The joint ca psule was penetrated and a 3-mm arthroscope was placed into the ankle joint. The skin surrounding each of the portals was carefully removed and the proximity of any nerves or vessels was measured with respect t o the arthroscope. At least one incidence of contact or penetration of a nerve or vessel was noted for each site. The anterocentral portal w as at greatest risk for nerve or vessel damage. The anterolateral, ant eromedial, and posterolateral portals were the safest areas for portal placement, with no penetration of neurovascular structures in any cas e.