Anatomic basis for a new ultrasound‐guided, mini‐invasive technique for release of the deep transverse metatarsal ligament

Nieves, Gabriel Camunas; Fernández-Gibello, Alejandro; Moroni, Simone; Montes, Rubén; Márquez, Javier; Ortiz, Mario Suárez; Vázquez, Teresa; Duparc, Fabrice; Moriggl, Bernhard; Konschake, Marko

doi:10.1002/ca.23692

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…Compared with the techniques reported in literature, our medial “ultra”-minimally invasive surgical approach, chosen because of its safety and the convenience of US guidance, protects all important anatomical structures 27 . During the last decade, some US-guided surgeries for other foot and ankle problems have been found to be safe and effective in both anatomical dissections of cadavers and clinical trials 28 , 29 . To the best of our knowledge, the present study describes the first ultra-minimally invasive US-guided technique with a medial approach for assessing an IO plasty.…”

Section: Discussionmentioning

confidence: 99%

The hallucal interphalangeal ossicle: anatomy and basis for ultrasound-guided surgical shaving

Moroni

Márquez²,

Fernández-Gibello³

et al. 2022

Sci Rep

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Painful lesions on the plantar aspect of the first interphalangeal joint (IPJ) of the hallux can be attributed to structures called ossicles, nodules, or sesamoids. The aims of the present study were first to verify that ultrasonography (US) is a high-sensitivity tool for diagnosing an interphalangeal ossicle (IO), and second to prove that US-guided-shaving surgery (“milling”) is a safe and feasible technique for remodeling the IO. The study is divided into three parts. In the first part, the prevalence of IOs was estimated in 12 cadaver feet using US, anatomical dissection, and fluoroscopy. In the second, a detailed US and morphological description of the IO was obtained. In the third, six cadaver feet were subjected to surgical milling. IO prevalence was 41.6% in gross anatomy, 41.6% in US examination and just 16.6% in fluoroscopy. The ossicles had a mean length of 4 mm (± 2 mm) and a width of 7 mm (± 2 mm). The ossicles could be completely shaved in all specimens without injuring important anatomical structures. Our results indicate that US is a more precise tool for diagnosing an IO than X-ray. Moreover, our US-guided mini-invasive surgical technique appears feasible and safe.

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Section: Discussionmentioning

confidence: 99%

The hallucal interphalangeal ossicle: anatomy and basis for ultrasound-guided surgical shaving

Moroni

Márquez²,

Fernández-Gibello³

et al. 2022

Sci Rep

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“…The four interspaces (intermetatarsal spaces) of the foot are separated into plantar and dorsal compartments by the DTMTL. 36 The DTMTL is a flat band extending between adjacent plantar plates of MTPJs and transversely holds the MT heads together. 37,38 It is an important landmark at the level of the MT heads as it can aid sonographic discrimination between CPDNs and the IMB (Figure 2).…”

Section: Sonographic Anatomy Of the Forefoot And Interspacesmentioning

confidence: 99%

Sonographic anatomy and technique to image the plantar digital nerves and aid identification of a Morton’s neuroma

Fenech

2023

Ultrasound

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Introduction: The anatomy of the forefoot is complex, and the sonographic assessment to image the plantar digital nerves and exclude, diagnose or discriminate between a Morton’s neuroma and intermetatarsal bursitis can be challenging. Topic description and discussion: A good appreciation of the sonographic anatomy, technique, normal and abnormal appearances is required to undertake a sonographic assessment of the forefoot and its interspaces, particularly the plantar digital nerves. This is unpacked in this paper with associated pictorial aids. Muscles, tendons, and ligaments of the interspaces and the nearby metatarsophalangeal joints and their associated soft-tissue structures are helpful sonographic landmarks to guide imaging and assessment of the common and proper plantar digital nerves and the intermetatarsal bursa. These need to be appreciated from both dorsal and plantar sonographic approaches, in both short- and long-axis imaging planes. Conclusion: Improved understanding of the anatomy and sonographic appearances of the interspace structures can enhance the sonographic assessment of the forefoot and improve diagnosis of a Morton’s neuroma and/or intermetatarsal bursitis when present to guide patient management.

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“…Beside open carpal tunnel release (CTR) and endoscopic procedures, minimally invasive procedures in various anatomical regions including the tarsal and carpal tunnel have attracted attention, as they are associated with little tissue trauma and are less invasive, thus producing fewer side-effects (7)(8)(9)(10)(11)(12)(13)(14)(15) . Petrover et al demonstrated the safety and efficacy of minimally invasive HRUS-guided CTR (16,17) .…”

Section: Introductionmentioning

confidence: 99%

Anatomical considerations of US-guided carpal tunnel release in daily clinical practice

Honis,

Gruber,

Honold

et al. 2023

J Ultrason

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Carpal tunnel syndrome is the most frequent compression neuropathy with an incidence of one to three subjects per thousand. As specific anatomical variations might lead to unintended damage during surgical interventions, we present a review to elucidate the anatomical variability of the carpal tunnel region with important considerations for daily clinical practice: several variants of the median nerve branches in and around the transverse carpal ligament are typical and must – similarly to the variant courses of the median artery, which may be found eccentric ulnar to the median nerve – be taken into account in any interventional therapy at the carpal tunnel. Unintended interference in these structures might lead to heavy arterial bleeding and, in consequence, even underperfusion of segments of the median nerve or, if neural structures such as variant nerve branches are impaired or even cut, severe pain-syndromes with a profound impact on the quality of life. This knowledge is thus crucial for outcome- and safety-optimization of different surgical procedures at the volar aspect of the wrist and surgical therapy of the carpal tunnel syndrome e.g., USguided carpal tunnel release, as injury might result in dysfunction and/or pain on wrist motion or direct impact in the region concerned. For most variations, anatomical and surgical descriptions vary, as official classifications are still lacking.

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Anatomic basis for a new ultrasound‐guided, mini‐invasive technique for release of the deep transverse metatarsal ligament

Cited by 6 publications

References 26 publications

The hallucal interphalangeal ossicle: anatomy and basis for ultrasound-guided surgical shaving

The hallucal interphalangeal ossicle: anatomy and basis for ultrasound-guided surgical shaving

Sonographic anatomy and technique to image the plantar digital nerves and aid identification of a Morton’s neuroma

Anatomical considerations of US-guided carpal tunnel release in daily clinical practice

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