Midfoot - Anterior Approach
This Midfoot – Anterior Approach course will teach you:
- To access the following bones of the midfoot:
- the three cuneiform bones
- the base of both the 1st and 2nd metatarsal.
Special attention is paid to the following hazards you may encounter during the Midfoot – Anterior Approach:
- Dorsal blood vessel injury
- Deep fibular nerve branches injury
- Neurovascular bundle injury
With the following tips you might perform the Midfoot – Anterior Approach even better:
- Alternative dorsal lateral incision to expose the cuboid, the 4th and/or 5th metatarsal
- Extensive dorsal salvage incision (EDSI) in cases of severe foot and ankle injury.
- Foot fasciotomy in case of compartment syndrome
- Medial cuneiform bone exposure by traction on tendons
- Distal incision extension towards the midline of the first web space
- Dorsal fascia of the foot closure
After studying the Midfoot – Anterior Approach course you are familiar with the most common complications:
- Foot compartment syndrome
- Wound complications
- Post-traumatic arthritis
- Sural nerve branch injury
- Foot deformity
- Delayed union
Step by step
Mark a 3 cm linear incision line on the skin between the extensor hallucis longus and brevis tendons, starting directly proximal to the the 1st and 2nd tarsometatarsal joints and extending distally.
Alternative dorsolateral incision
A dorsolateral incision can be made in case the cuboid, the 4th and/or 5th metatarsal need to be exposed. The incision is centered over the tarsometatarsal joints area, roughly in line with the fourth metatarsal, and follows similar steps to the ones described in this procedure.
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