An anatomic comparison of venous damage resulting from 2 dorsal surgical approaches to proximal interphalangeal joint arthroplasty.
Proximal interphalangeal joint arthroplasties were performed on 40 toes of 10 fresh-frozen cadaveric feet. Twenty toes had a transverse elliptical incision of skin and extensor mechanism, and 20 had a longitudinal incision with transverse excision of extensor mechanism. Venous anatomy, including damage to the dorsal collateral veins, was noted. In the transverse-incision group, 14 (70%) of 20 toes had 1 dorsal vein transected, and 2 (10%) of 20 toes had both dorsal veins transected; in the longitudinal-incision group, no dorsal collateral veins were injured. As transverse incisions carry a high risk for damaging the dorsal collateral veins, and such damage may contribute to postoperative swelling, care should be taken to protect these veins. Longitudinal incisions are less likely to damage these venous structures.
Stratton
Nicolas J
NJ
Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Thordarson
David B
DB
D001178:Arthroplasty / Q000009:adverse effects* / Q000379:methods; D002102:Cadaver; D003097:Collateral Circulation; D017885:Collateral Ligaments / Q000098:blood supply / Q000601:surgery; D006801:Humans; D014033:Toe Joint / Q000098:blood supply* / Q000601:surgery*