Cincinnati Incision Approach for Posterior Ankle and Calcaneal Pathology: Technique Tip

Feldbrin, Zeev; Lipkin, Alexander

doi:10.3113/fai.2011.0092

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…At the five-month clinical review, the patient had satisfactory clinical results without any major complication or pain, which may be partially attributed to the choice of skin incision. Surgery to the hindfoot can be associated with high rates of complications including prolonged wound healing, sural nerve injury, and ugly scar formation [14–16] . However, the Cincinnati incision, which was initially described by Crawford et al in 1982 preserves the neurovascular and lymphatic supply of the foot, has the advantages of almost invisible scar formation and fairly low risks of complications [17,18] .…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional printed calcaneal prosthesis following total calcanectomy

Imanishi

Choong

2015

International Journal of Surgery Case Reports

124

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Section: Discussionmentioning

confidence: 99%

Three-dimensional printed calcaneal prosthesis following total calcanectomy

Imanishi

Choong

2015

International Journal of Surgery Case Reports

124

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“…19 Major wound complications are rare, but potentially devastating; 20 however, the most common complications reported are hypersensitivity, hypertrophy and numbness of the scar. 28 Delayed wound healing, superficial infection and deep-vein thrombosis may also occur. 19,20 In the present series, two patients had delayed wound healing, with no growth from bacterial swabs.…”

Section: Discussionmentioning

confidence: 99%

Safety and outcome of surgical debridement of insertional Achilles tendinopathy using a transverse (Cincinnati) incision

Maffulli

Buono

Testa³

et al. 2011

The Journal of Bone and Joint Surgery. British volume

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This is a prospective analysis on 30 physically active individuals with a mean age of 48.9 years (35 to 64) with chronic insertional tendinopathy of the tendo Achillis. Using a transverse incision, the tendon was debrided and an osteotomy of the posterosuperior corner of the calcaneus was performed in all patients. At a minimum post-operative followup of three years, the Victorian Institute of Sports Assessment scale -Achilles tendon scores were significantly improved compared to the baseline status. In two patients a superficial infection of the wound developed which resolved on antibiotics. There were no other wound complications, no nerve related complications, and no secondary avulsions of the tendo Achillis. In all, 26 patients had returned to their pre-injury level of activity and the remaining four modified their sporting activity. At the last appointment, the mean pain threshold and the mean post-operative tenderness were also significantly improved from the baseline (p < 0.001). In patients with insertional tendo Achillis a transverse incision allows a wide exposure and adequate debridement of the tendo Achillis insertion, less softtissue injury from aggressive retraction and a safe osteotomy of the posterosuperior corner of the calcaneum.In insertional Achilles tendinopathy, symptoms occur at the bone-tendon junction. The distal portion is affected in 24% of patients, 1 but the actual incidence of insertional Achilles tendinopathy is unknown. Conservative measures are helpful in most patients, and include rest, ice, non-steroidal anti-inflammatory drugs, careful selection of footwear and activity modification. 2 Eccentric exercises of the gastro-soleus complex are effective in only 32% of patients, with 67% of promising clinical results in patients undergoing a new model of painful eccentric calf-muscle training. 3

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“…All patients were operated on in the prone position using an extended Cincinnati incision for surgical access. [5] A proximal thigh tourniquet was used. Post-total calcanectomy, no formal reconstruction, was undertaken except for reattachment of the tendo-Achilles to the talus using Mitek sutures.…”

mentioning

confidence: 99%

Calcanectomy in primary high-grade sarcomas: Foot salvage without the need for any reconstruction

Khan

Shaheen²,

Board

2022

JMSR

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The calcaneum is a rare site for primary bone sarcomas. Calcanectomy is not considered for high-grade malignancies due to anticipated issues with obtaining negative margins, providing adequate soft-tissue coverage, and preserving satisfactory function. A below-knee amputation overcomes these difficulties and is very functional and, thus, the preferred local control option. The aim of this study is to evaluate the role of total calcanectomy, without any formal reconstruction, in high-grade calcaneal sarcomas. Over 14 years, three patients with high-grade calcaneal sarcomas underwent limb salvage surgery as opposed to amputation for their primary malignancy. Total calcanectomy was undertaken using a Cincinnati incision. No formal “calcaneal” reconstruction was undertaken after resection, essentially leaving the patient with an excision arthroplasty through the subtalar joint. The Achilles tendon was reattached to the posterior talus. Negative resection margins were achieved in all cases with the primary wound closure. Two patients are alive with no evidence of disease at 15 and 10 years. The third patient, at over 1 year postoperatively, has no evidence of local disease recurrence but has had metastasectomy for documented pulmonary metastases at the presentation. The average musculoskeletal tumor society score was 85.5%, and the average Toronto extremity salvage score was 88.5%. In our experience, even high-grade malignancies at this unusual site are potentially amenable to limb salvage. Our results show that perhaps ablative surgery should not be considered inevitable. Good functional outcomes can be achieved without reconstruction, thus minimizing potential “construct”-related morbidities.

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Cincinnati Incision Approach for Posterior Ankle and Calcaneal Pathology: Technique Tip

Abstract: For information on pricings and availability of reprints, call 410-494-4994, x232.

Cited by 3 publications

References 8 publications

Three-dimensional printed calcaneal prosthesis following total calcanectomy

Three-dimensional printed calcaneal prosthesis following total calcanectomy

Safety and outcome of surgical debridement of insertional Achilles tendinopathy using a transverse (Cincinnati) incision

Calcanectomy in primary high-grade sarcomas: Foot salvage without the need for any reconstruction

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