title: Arthroscopic triple fusion joint preparation using two lateral portals: a cadaveric study to evaluate efficacy and safety.
abstract: BACKGROUND
  Arthroscopic triple fusion has several advantages over open techniques, but its use has yet to become widespread. Preliminary published techniques use five portals with neurovascular risk. Our aim was to assess the safety and efficacy of an alternative lateral two portal technique.
  
  
  METHODS
  Four cadaveric hindfeet were arthroscopically prepared for a triple fusion using two lateral portals. The distance to relevant subcutaneous nerves was measured as well as the prepared joint surface percentage.
  
  
  RESULTS
  Mean distance from mid-lateral portal to the nearest sural nerve branch was 22.3mm (range 20-24mm) and from the dorsolateral portal to the intermediate branch of the superficial peroneal nerve was 7.8mm (range 4-11mm). Mean percentages of joint preparation were 63% (talar head), 62% (navicular), 75% (calcaneum) and 74% (cuboid).
  
  
  CONCLUSIONS
  Two lateral arthroscopic portals allow adequate joint preparation for triple fusion procedures. The proximity of subcutaneous nerves is important to appreciate when using these portals.
authors.affiliation: Avon Orthopaedic Centre, North Bristol Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK. Electronic address: adrianhughes42@gmail.com.
authors.forename: Adrian M
authors.initials: AM
authors.lastname: Hughes
authors.affiliation: Avon Orthopaedic Centre, North Bristol Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK.
authors.forename: Oliver
authors.initials: O
authors.lastname: Gosling
authors.affiliation: Avon Orthopaedic Centre, North Bristol Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK.
authors.forename: James
authors.initials: J
authors.lastname: McKenzie
authors.affiliation: University Hospitals Bristol, Bristol Royal Infirmary, UK.
authors.forename: Rouin
authors.initials: R
authors.lastname: Amirfeyz
authors.affiliation: Avon Orthopaedic Centre, North Bristol Trust, Southmead Hospital, Westbury-on-Trym, Bristol BS10 5NB, UK.
authors.forename: Ian G
authors.initials: IG
authors.lastname: Winson
mesh_terms: D000368:Aged; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D002102:Cadaver; D005260:Female; D005528:Foot / Q000294:innervation; D033023:Foot Joints / Q000601:surgery*; D006801:Humans; D008297:Male; D010543:Peroneal Nerve / Q000033:anatomy & histology; D013497:Sural Nerve / Q000033:anatomy & histology; D016896:Treatment Outcome
keywords: Arthroscopy; Cadaveric; Efficacy; Safety; Triple fusion