Arthroscopic ankle arthrodesis (AAA) is minimally invasive surgery, whereby percutaneous screw fixation is used through the medial aspect of the distal tibia to fusion the ankle, but it carries the risk of the saphenous vein and nerve injuries. The near-infrared (NIR) vascular imaging system, the VeinViewer
Ten patients with the ankle osteoarthritis underwent AAA. Three screw insertion sites (proximal as number 1, anterior distal as number 2, and posterior distal as number 3) were marked and then the vein was depicted on the medial malleolus using the VeinViewer
The distance of number 1, 2, and 3 from the vein was 2.4 ± 1.4 mm (range from 0 to 5 mm), 6.3 ± 6.6 mm (range from 0 to 20 mm) and 3.5 ± 3.1 mm (range from 0 to 11 mm) respectively. In anterior screw insertion site, 3 of 10 cases showed just on the vein. The veins were observed at the anterior region from the center axis of the tibia more than 75% of ankles which was suspected as the greater saphenous vein with closely running of the saphenous nerve, but also other regions had the crossing vein.
Percutaneous screw fixation during AAA runs the risk of causing the saphenous structure injury. The NIR light imaging system is beneficial in reducing the complications of saphenous structure damage in AAA.