Simplified Setup to Achieve Distraction for Toe Arthroscopy

Abstract

Toe arthroscopy has historically had limited applications but is beginning to emerge as a viable treatment option for select toe pathologies, and continues to have expanding indications as technology and techniques improve. Toe arthroscopy has used a multitude of distraction techniques to perform the procedures but all have had limited success. Thus, we propose a simple toe arthroscopy distraction technique that uses an external positioning arm to allow the surgeon to apply manual traction in multiple positions without the use of an assistant, external weights, or any reprocessed sterile equipment.

Arthroscopy of the First Metatarsophalangeal Joint

“…U literaturi su opisane različite metode distrakcije, od invazivnih (kada je stopalo ovješeno na držač s pomoću vanjskog fi ksatora ili Kirschnerove žice postavljene kroz distalni članak palca), preko neinvazivnih metoda putem trakcije kože (najpoznatija je kineska klopka koja je spojena preko poluge s utegom od 2 kg), do najčešće upotrebljavane manualne distrakcije zgloba koju i mi rabimo u Klinici za ortopediju Kliničkoga bolničkog centra Zagreb, Medicinskog fakulteta Sveučilišta u Zagrebu (dalje u tekstu Klinika). 12,13 Za razliku od ostalih metoda, manualna distrakcija koju izvodi asistent nije stalna i jednaka tijekom cijeloga kirurškog zahvata, već se primjenjuje samo u onim trenucima kada su operateru potrebni bolji pregled i pristup određenim zglobnim strukturama.…”

Appropriate Distraction Strength For Metatarsophalangeal Joint Arthroscopy

“…Several different skeletal and soft tissue traction techniques have been introduced, including distraction methods using manual distraction 2 , mini external xator 3 and Kirshner wire 4 . Other methods using nger trap and positioning arm have also been devised 5 . However, few studies have studied the proper distraction strength, joint spacing, and factors affecting the distraction regardless of the distraction method.…”

Dorsal Cheilectomy Using Great Toe Metatarsophalangeal Joint Arthroscopy for the Treatment of Hallux Rigidus

“… 5 , 6 Recent technological advances have made the great toe MTPJ more accessible using arthroscopic techniques, including the creation of 1.9-mm high-definition cameras and 1.4-mm bipolar radiofrequency ablation devices. 7 Even with the aforementioned technological advances in performing great toe MTPJ arthroscopy, contraindications still exist, including severe soft-tissue swelling, arterial insufficiency, infection, and presence of a large osteophyte. 8 …”