Interosseous membrane window size for tibialis posterior tendon transfer-Geometrical and MRI analysis.
Foot Ankle Surg
; 22(3): 196-199, 2016 Sep.
Article
em En
| MEDLINE
| ID: mdl-27502230
ABSTRACT
BACKGROUND:
Tibialis posterior (TP) tendon transfer through the interosseous membrane is commonly performed in Charcot-Marie-Tooth disease. In order to avoid entrapment of this tendon, no clear recommendation relative to the interosseous membrane (IOM) incision size has been made.OBJECTIVE:
Analyze the TP size at the transfer level and therefore determine the most adequate IOM window size to avoid muscle entrapment.METHODS:
Eleven lower extremity magnetic resonances were analyzed. TP muscle measurements were made in axial views, obtaining the medial-lateral and antero-posterior diameter at various distances from the medial malleolus tip. The distance from the posterior to anterior compartment was also measured. These measurements were applied to a mathematical model to predict the IOM window size necessary to allow an ample TP passage in an oblique direction.RESULTS:
The average tendon diameter (confidence-interval) at 15cm proximal to the medial malleolus tip was 19.47mm (17.47-21.48). The deep posterior compartment to anterior compartment distance was 10.97mm (9.03-12.90). Using a mathematical model, the estimated IOM window size ranges from 4.2 to 4.9cm.CONCLUSION:
The IOM window size is of utmost importance in trans-membrane TP transfers, given that if equal or smaller than the transposed tendon oblique diameter, a high entrapment risk exists. A membrane window of 5cm or 2.5 times the size of the tendon diameter should be performed in order to theoretically diminish this complication.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Transferência Tendinosa
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Imageamento por Ressonância Magnética
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Disfunção do Tendão Tibial Posterior
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Articulação do Tornozelo
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Foot Ankle Surg
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2016
Tipo de documento:
Article