title: Anatomic structures at risk: curved hindfoot arthrodesis nail--a cadaveric approach.
abstract: Retrograde intramedullary nailing of the hindfoot and ankle is an established procedure for salvage of severe foot and ankle deformity, arthritis, tumor, and instability. In the present study, retrograde hindfoot (tibiotalocalcaneal) arthrodesis nailing was performed using a standardized technique on 7 cadaver specimens by trained senior surgeons. The specimens were then dissected to determine the distance of the subcalcaneal structures at risk from the insertion point of the nail. The findings showed that the distance of the lateral neurovascular bundle from the edge of the nail was 6.5 (range 3.5 to 8, 95% confidence interval 5.9 to 7.1) mm. No neurovascular bundle was compromised, and all were within a previously described "safe window."
authors.affiliation: Specialist Registrar, West Midlands Deanery, Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry, Shropshire, United Kingdom. Electronic address: tknight@doctors.org.uk.
authors.forename: Timothy
authors.initials: T
authors.lastname: Knight
authors.affiliation: Orthopaedic Consultant Surgeon, St Mary's Hospital, London, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Rosenfeld
authors.affiliation: Orthopaedic Consultant Surgeon, St Thomas' Hospital, London, United Kingdom.
authors.forename: Ioan Tudur
authors.initials: IT
authors.lastname: Jones
authors.affiliation: Orthopaedic Consultant Surgeon, Heatherwood and Wexham Park Hospitals, Berkshire, United Kingdom.
authors.forename: Callum
authors.initials: C
authors.lastname: Clark
authors.affiliation: Orthopaedic Consultant Surgeon, Dorset County Hospital, Dorset, United Kingdom.
authors.forename: Nick
authors.initials: N
authors.lastname: Savva
mesh_terms: D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D002102:Cadaver; D002111:Calcaneus / Q000033:anatomy & histology / Q000098:blood supply / Q000294:innervation / Q000601:surgery; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D009262:Nails; D059348:Peripheral Nerve Injuries / Q000209:etiology / Q000517:prevention & control; D013628:Talus / Q000601:surgery; D013977:Tibia / Q000601:surgery; D057772:Vascular System Injuries / Q000209:etiology / Q000517:prevention & control
keywords: HAN; ankle; arthritis; cadaver; intramedullary nail; tibiotalocalcaneal fusion