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Technique of Prone Ankle and Subtalar Arthroscopy

Phisitkul, Phinit MD; Junko, Jeffrey T. MD; Femino, John E. MD; Saltzman, Charles L. MD; Amendola, Annunziato MD

Techniques in Foot & Ankle Surgery: March 2007 - Volume 6 - Issue 1 - p 30-37
doi: 10.1097/01.btf.0000235419.53662.95

Intra-articular and periarticular lesions in the posterior aspect of the ankle and subtalar joints are challenging to address surgically. Open approaches to this area often require neurovascular dissection or malleolar osteotomies that may result in considerable postoperative pain and risk of soft tissue complications. Arthroscopy of the hindfoot in the prone position is a novel approach using posteromedial, posterolateral, and, if needed, accessory posterolateral portals. This approach has been successfully used for the treatment of various clinical entities with low complications. The key to its use is meticulous arthroscopic technique together with the awareness of important anatomical structures. Especially important are the flexor hallucis longus tendon, the posteromedial neurovascular bundles, and the sural nerve. This article describes the authors' preferred technique and its applications with literature reviews.

University of Iowa Hospitals and Clinics, Iowa City, IA

Address correspondence and reprint requests to Ned Amendola, MD, Orthopaedic Department, University of Iowa Hospitals and Clinics, 200 Hawkins Dr., Iowa City, IA 52242. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.