Risk of neurovascular injury from fine wires in the foot and ankle
Research type
Research Study
Full title
Risk of neurovascular injury with fine wire insertion in the ankle, hind- and mid-foot
IRAS ID
228273
Contact name
Ross L Muir
Contact email
Duration of Study in the UK
0 years, 0 months, 2 days
Research summary
Insertion of fine wires for ring fixators risks injury to neurovascular structures, despite the use of previously described “safe corridors” for wire insertion. There are, however, currently no anatomic studies detailing the risk of injury from wires inserted into the ankle, midfoot and the much of the hindfoot.
10 cadaveric legs will used for this study. Standard fine wire placement will be performed in the distal tibia, talus and metatarsal bases to replicate normal practice (Based on “Atlas for the insertion of transosseous wire and half pins. Ilizarov Method. By M Catagni, 2003 © Medi Surgical Video). A further wire will be inserted through a stab incision over the sustentaculum tali. Blunt dissection will be carried out down to bone (flexor retinaculum split in line of fibres) and the wire will be introduced through a 2mm drill sleeve with blunt trochar to protect the surrounding soft tissue sructures. We hope that this new method allows safer wire insertion in the anterior calcaneus.
Dissections of the legs will then be performed via pre-agreed incisions to analyse the relationship of the wires to the peroneal nerves at each level. Measurements will be made with digital Vernier calipers accurate to 0.01mm.
Results: Data would be analysed and results would be published in peer reviewed journals and presented at National or International Limb Reconstruction meetings.
This is an important anatomical study as the consequences of nerve injuries can be severe and patients may not fully recover function both from a motor and sensory aspect.
If nerve injuries are encountered or if the wires pass within an unacceptably short distance from nerves, changes to future surgical technique may be warranted to improve patient safety.REC name
London - South East Research Ethics Committee
REC reference
17/LO/1081
Date of REC Opinion
4 Jul 2017
REC opinion
Favourable Opinion