Accuracy of posterior subtalar joint injection without fluoroscopy.

Clinical Orthopaedics and Related Research
Kevin L KirkLew C Schon

Abstract

Injection into the posterior subtalar joint has not been validated for accuracy using radiographic end points. We asked whether needle placement into a normal posterior subtalar joint could be performed accurately and selectively by experienced surgeons without fluoroscopic guidance. Three fellowship-trained orthopaedic foot and ankle surgeons each injected the posterior subtalar joint of 20 cadaveric specimens using an anterolateral approach. Fluoroscopic images were obtained by an independent investigator and blinded. A separate fellowship-trained foot and ankle surgeon interpreted the images. Of 60 injections, 58 were accurate and two were extraarticular based on interpretation by an independent foot and ankle surgeon. Extravasation into the ankle occurred in 14 samples and into the peroneal sheath in two samples. Experienced surgeons can place intraarticular injections into a radiographically normal posterior subtalar joint without fluoroscopy with a high degree of accuracy. However, extravasation into the ankle or peroneal tendon sheath occurred in an unpredictable fashion, suggesting selectivity of injection placement is relatively limited without the use of fluoroscopy. Fluoroscopy may not be necessary for injections use...Continue Reading

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Citations

Nov 6, 2015·The British Journal of Radiology·Eleni E DrakonakiRoland Watura
Sep 17, 2009·Foot & Ankle International·Shaun KhoslaJudith F Baumhauer
Feb 25, 2015·PM & R : the Journal of Injury, Function, and Rehabilitation·Jonathan T FinnoffJay Smith
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