An Anatomic Safe Zone for Posterior Ankle Arthroscopy: A Cadaver Study

Posterior ankle arthroscopy has traditionally been associated with concern for injury to the posterior tibial nerve and vessels, and this concern is greatest when the patient is positioned supine. Positioning the patient prone could be a safer method for posterior ankle arthroscopy. The purpose of this cadaver study was to determine the anatomic safe zone devoid of vital structures relative to the posteromedial and posterolateral arthroscopic portals created. In addition, exposure of the posterior ankle was evaluated by direct visualization and fluoroscopy to determine the relative utility of these portals. Based on our findings, which are consistent with other previously reported results, we believe that a wide range of ankle pathology can be suited to treatment by means of posterior arthroscopy with the patient in the prone position.