'Sounding' the bolt: confirming the position of the locking bolts in an intramedullary nail.

Abstract

We present a technique for stabilising the unstable calcaneocuboid joint. The joint is approached laterally, elevating the extensor digitorum brevis muscle. Once the joint is exposed, two parallel tunnels are drilled into the calcaneal neck and cuboid. The harvested gracilis tendon is prepared with whip stitches, and passed through the tunnels in a plantar-dorsal manner. The dorsal limbs of the graft are then pulled across the joint in parallel. The ends are fixed in the calcaneum and cuboid, respectively, using biotenodesis screws (Arthrex; Florida, USA). This technique recreates the dorsal support of the cuboid part of the bifurcated ligament and the dorsal calcaneocuboid ligament, while also augmenting the plantar calcaneocuboid ligament. So far, we have used this technique in one patient with a good result. Figure 1 Anatomical calcaneocuboid joint stabilisation.