Artroscopia da articulação metatarsofalângica dos dedos menores: anatomia descritiva e dissecção comparativa

Abstract

Introduction: The technological advances of the last decades have made it possible to access more delicate and efficient surgical instruments, resulting in a significant boost to the arthroscopy of the small joints of the hands and feet. Although there is growing interest in these procedures, there are no publications describing the surgical technique or the details of the regional arthroscopic anatomy. Objective: to evaluate the precision of metatarsophalangeal arthroscopy of the small fingers to identify the most important anatomical structures of these joints. Methods: An arthroscopic examination of 18 metatarsophalangeal joints of six normal fresh frozen feet was performed. The second, third and fourth metatarsophalangeal joints were studied due to the high incidence of diseases found in these joints. During arthroscopy, each identified anatomical structure was named and marked with different colored sutures using straight suture needles. After the arthroscopic identification and marking procedure, each metatarsophalangeal joint was dissected and all anatomic structures were clearly identified. With these data, the correlation between the arthroscopic visualization and the direct visualization of a normal metatarsophalangeal joint was established. Results: Considering the articular regions, there was a precision of 91% for the medial gutter, 98% for the lateral gutter, while the precision of the central region reached 100%. The overall precision for the metatarsophalangeal joints of the small fingers was 96%. Conclusion: Arthroscopy of the metatarsophalangeal joints of the central rays (II, III and IV) presents high precision (96.3%) in the identification of normal anatomical structures. Clinical relevance: The high concordance between anatomic dissection and metatarsophalangeal arthroscopy allows us to consider this feature as a valuable tool in the diagnosis and treatment of these joints, increasing the range of indications with this method. Keywords: Arthroscopy. Metatarsophalangeal joint. Lesser toes.