Microvasculature of the Plantar Plate Using Nano–Computed Tomography
| Autor: | Aaron McPheters, Paul G. Talusan, Karl J. Jepsen, Natalie Singer, Jaron Scott, Fred T. Finney, James R. Holmes |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Metatarsophalangeal Joint Plantar Plate Lesser toe Adolescent Computed tomography Article 03 medical and health sciences 0302 clinical medicine Cadaver medicine Humans Nanotechnology Orthopedics and Sports Medicine Plantar plate Aged 030222 orthopedics medicine.diagnostic_test business.industry 030229 sport sciences Middle Aged body regions medicine.anatomical_structure Microvessels Female Surgery Tomography X-Ray Computed business Biomedical engineering |
| Zdroj: | Foot & Ankle International. 40:457-464 |
| ISSN: | 1944-7876 1071-1007 |
| DOI: | 10.1177/1071100718816292 |
| Popis: | Background: Lesser toe plantar plate attenuation or disruption is being increasingly implicated in a variety of common clinical conditions. A multitude of surgical techniques and devices have been recently developed to facilitate surgical repair of the plantar plate. However, the microvascular anatomy, and therefore the healing potential in large part, has not been defined. We investigated the microvasculature of the plantar plate by employing a novel technique involving microvascular perfusion and nano–computed tomography (nano-CT) imaging. Methods: Twelve human adult cadaveric lower extremities were amputated distal to the knee. The anterior and posterior tibial arteries were perfused with a barium solution. The soft tissues of each foot were then counterstained with phosphomolybdic acid (PMA). The second through fourth toe metatarsophalangeal (MTP) joints of 12 feet were imaged with nano-CT at 14-micron resolution. Images were then reconstructed for analysis of the plantar plate microvasculature and calculation of the vascular density along the length of the plantar plate. Results: A microvascular network extends from the surrounding soft tissues at the attachments of the plantar plate on both the metatarsal and proximal phalanx. The midsubstance of the plantar plate appears to be relatively hypovascular. Analysis of the vascular density along the length of the plantar plate demonstrated a consistent trend with increased vascular density at approximately the proximal 29% and distal 22% of the plantar plate. Conclusion: There is a vascular network extending from the surrounding soft tissues into the proximal and distal attachments of the plantar plate. Clinical relevance: The hypovascular midportion of the plantar plate may play an important role in the underlying pathoanatomy and pathophysiology of this area. These findings may have significant clinical implications for the reparative potential of this region and the surgical procedures currently described to accomplish anatomic plantar plate repair. |
| Databáze: | OpenAIRE |
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