Minimally Invasive Surgery of the Foot and Ankle by Nicola Maffulli & Mark Easley

Author:Nicola Maffulli & Mark Easley
Language: eng
Format: epub
Publisher: Springer London, London

The first stab incision is made at the inferior medial calcaneal mark. Make a stab incision along the lines of the proposed osteotomy full thickness. Using a curved hemostat, bluntly deepen the incision down to the calcaneus. Next, with the curved end pointing toward the skin, create a tunnel toward the superior incision making sure that the tip of the hemostat is directly over the calcaneus as this blunt dissection is performed. The tunnel is made deep to the neurovascular structures. It is important to keep the tip of the hemostats against the calcaneus while tunneling superiorly. Once the superior medial landmark is reached, tent the skin and make a stab incision with in the resting skin line. The tip of the curved hemostat is then exited out the incision site. This is the site that the gigli saw will be introduced. Open the tip of the hemostat and clamp a 12 in. flexible gigli saw. Pull the hemostats inferiorly through the tunnel, and through the inferior incision. One loop of the gigli saw is now exiting the medial inferior incision. Unclamp the hemostat from the end of the gigli saw (Fig. 19.2).

Fig. 19.2(a) The first stab incision is made and deepened on the medial side down to the calcaneus to perform the medial tunnel for the gigli saw. (b) The gigli saw in place in the medial tunnel

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