Atlas of “recommended positions” for insertion of transosseous elements through foot

Purpose. To create an improved atlas designed to insert transosseous elements through foot bones. Materials and Methods. The study performed in two stages using eight frozen (fixed) and ten non-fixed cadaveric preparations of leg-foot complex. The foot was divided in 14 transverse and 3 oblique levels. 12 positions were determined at each of the levels for each bone of the level. Both prohibited positions (the projection of significant blood vessels and nerves) and safe positions determined in the frozen preparations. The displacement amounts of soft tissues in the non-fixed preparations studied relative to foot bones for movements in the ankle, metacarpophalangeal, and interphalangeal joints. The positions with minimum displacement of soft tissues and with the absence of significant vessels and nerves were designated as “recommended positions” for insertion of wires and half-pins in transosseous osteosynthesis. Results. The data obtained during the experiment were processed graphically and presented as an atlas each of 17 levels in which included the information about “Contraindicated positions”, “Safe positions” and «Recommended positions” for transosseous element insertion. It is the most detailed atlas of those known today. Conclusion. The use of the developed atlas will be useful for specialists engaged in the field of correcting complex foot deformities and applying external fixation for fractures.