Foot and Ankle Trauma Injuries by Walter Daghino Alessandro Massè & Daniele Marcolli

Author:Walter Daghino, Alessandro Massè & Daniele Marcolli
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Furthermore it is advisable to proceed with a motorized saw only to accomplish the first part of the bony cut, finishing it with a chisel, avoiding to create chondral injuries from the high temperature generated by the saw and simultaneously creating surfaces that help the correct matching during the synthesis.

During the execution of this extended access, it can be useful to isolate the tibialis posterior neurovascular bundle, to avoid any iatrogenic injuries during the reduction manoeuvres, especially when a body fragment is present, which can modify the normal route of the bundle (see Fig. 4.5).

Fig. 4.5Clinical case: complex fracture of the talus and the medial malleolus, with medial dislocation of the talar body; (a) X-ray evaluation; (b) the CT shows the entity and the extension of the dislocation; (c) intraoperative image, where it is possible to understand the compression of the dislocated body (white arrow) on the retracted neurovascular bundle (protected by a white lace), isolated and protected during the dissection; (d) once that the surgical preparation is completed, the compressive effect carried out by the dislocated body on the posterior tibial neurovascular bundle is more evident

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