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Purpose: The purpose of our study was to systematize the arterial supply of the talus and characterize the vessel damage occurring in the talus after total ankle replacement. Previous studies exist using vascular injection to visualize the topic [Giebel et al. (Surg Radiol Anat 19:231-235, 1997); Mulfinger and Trueta (J Bone Joint Surg Br 52:160-167, 1970); Peterson et al. (Acta Orthop Scand 46:1026-1034, 1975); Peterson and Goldie (Acta Orthop Scand 45:260-270, 1974)]. The vascularization of the talus has previously been described by various authors [Aquino et al. (J Foot Surg 25:188-193, 1986); Haliburton et al. (J Bone Joint Surg Am 40:1115-1120, 1958); Mulfinger and Trueta (1970); Peterson et al. (1975); Wildenauer (Z Orthop Ihre Grenzgeb 113:730, 1975)]. The plastination method provides excellent intraosseous view of the arterial system and offers a helpful method to demonstrate the influence of the Scandinavian Total Ankle Replacement (STAR) on the blood vessels., Methods: In a first step, the nutritive foramina were analyzed on 20 macerated cadaver feet. After this, the articular surface was measured with a print using Optosil. The next step was the visualization of the vascularization of the talus using the plastination method. After vascular injection, a STAR was implanted in two specimens and a plastination was done., Results: The highest amount and density of nutritive foramina were found in the sulcus tali. Using the imprint technique for the examined tali, we found a mean area covered by cartilage of 56.9% in comparison to the total surface. The deep fin of STAR has the potential to eliminate important blood vessels of the talus., Conclusion: The plastination methods were useful methods to analyze the arterial supply of the talus. In our study, the STAR showed a dominant influence on the vascularization of the talus. The fin appeared to be too long. A design modification with a short fin could provide the arterial supply, but should be tested biomechanically.

Recent publications have renewed the debate regarding the number of foot compartments. There is also no consensus regarding allocation of individual muscles and communication between compartments. The current study examines the anatomic topography of the foot compartments anew using 32 injections of epoxy-resin and subsequent sheet plastination in 12 cadaveric foot specimens. Six compartments were identified: dorsal, medial, lateral, superficial central, deep forefoot, and deep hindfoot compartments. Communication was evident between the deep hindfoot compartment and the superficial central and deep central forefoot compartments. In the hindfoot, the neurovascular bundles were located in separate tissue sheaths between the central hindfoot compartment and the medial compartment. In the forefoot, the medial and lateral bundles entered the deep central forefoot compartment. The deep central hindfoot compartment housed the quadratus plantae muscle, and after calcaneus fracture could develop an isolated compartment syndrome.

The functional influence of the medial collateral ligament on the medial meniscus is still discussed controversially. Commonly, a strong fixation of the meniscus by the collateral ligament is described. Injury to the medial meniscus is explained by its reduced mobility due to its strong adherence to the medial collateral ligament. The analysis of 10 plastinated series of the medial femorotibial compartment prove that only few fibres of the ligament radiate into the meniscus. To define the possible contribution of these fibers to the stability of the medial meniscus, experiments on two fresh frozen knee joints were performed. The distal femur was separated by cutting the capsule. The medial collateral ligament was detached carefully from its femoral insertion. The tibial head with both menisci was fixed in a clamping system. A translucent, exact acrylic glass copy of the femoral component to which the medial collateral ligament was reinserted, allowed studying the behaviour of the medial meniscus under axial compression (500 N). Firstly, stress was applied while the collateral ligament was proximally fixed and under tension; then the same experiment was performed after femoral detachment of collateral ligament. All plastinated series revealed only some deep and tender fibrous bundles of the medial collateral ligament radiating into the medial meniscus proximally and posteriorly. The behaviour of medial meniscus was exactly the same in both stress experiment series. The conclusion is that there is no relevant influence of the medial collateral ligament on the stability of the medial meniscus.