Video

This video shows the forced passive hyper plantar flexion test which is part of the physical examination. For the complete physical examination click HERE. 

Positioning

The procedure is carried out as outpatient surgery under general anaesthesia or spinal anaesthesia. The patient is placed in a prone position. The involved leg is marked with an arrow to avoid wrong side surgery. A tourniquet is inflated around the thigh for haemostasis. A small support is placed under the lower leg, making it possible to move the ankle freely. 

Instruments

For irrigation normal saline is used, however ringers solution is also possible. Gravity inflow is adequate for irrigation.

A 4.0 mm arthroscope with an inclination angle of 30 degrees is routinely used, permitting excellent visualization. 
Furthermore, a blade, probes, elevators, graspers, and basket forceps are used.
We use a non-invasive soft-tissue distraction device when manual distraction is not sufficient.

Portals

For endoscopic treatment of os trigonum, the standard 2- portal hindfoot approach is used. For portal placement, please click here.