{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:09Z","timestamp":1783509309391,"version":"3.55.0"},"reference-count":20,"publisher":"MDPI AG","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Medial column nails have been introduced into Charcot\u2019s neuroarthropathy reconstruction as superconstruct fixation with high fatigue strength and pullout resistance. Similar to intramedullary nailing throughout other long-bone fixation, injury to neurovascular and musculotendinous structures secondary to percutaneous interlocking screw fixation may exist. We sought to identify structures at risk for injury during the interlocking of a medial column nail.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    Medial column nails were inserted into ten cadaveric limbs. The proximal (talar), middle (first metatarsal), and distal (first metatarsal) locations for the interlocking screws were drilled, and a 0.062 Kirschner wire was inserted into respective drillholes to simulate interlocking screws. After dissection, the distances of each Kirschner wire to nearby anatomical structures were measured. Levels of risk were assigned to each soft-tissue structure based on distance to each Kirschner wire: high (0\u20133.5 mm), intermediate (3.6\u20137.0 mm), and low (&gt;7.0 mm). A 3.5-mm threshold for each category was used because this represented a multiple of the diameter of the interlocking screws. Mean \u00b1 SD and ranges are reported for structures at high and intermediate risk for injury.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    Proximally, the deltoid ligament (ten of ten), posterior tibial tendon (eight of ten), and saphenous vein (six of ten) were at high or intermediate risk for injury consistently. At the middle screw, the medial dorsal cutaneous nerve and the medial marginal vein were at high or intermediate risk in ten and eight specimens, respectively. At the distal interlocking screw, the medial dorsal cutaneous nerve was at high risk for injury in all ten specimens.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    There is high and intermediate risk to many musculotendinous and neurovascular structures when performing percutaneous interlocking screws in a medial column nail. These findings serve to educate surgeons of the anatomical considerations they must have when performing medial column nailing for reconstruction of Charcot\u2019s foot.\n                  <\/jats:p>","DOI":"10.7547\/23-110","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T14:39:38Z","timestamp":1765895978000},"source":"Crossref","is-referenced-by-count":0,"title":["Anatomical Structures at Risk After Medial Column Nailing"],"prefix":"10.3390","volume":"115","author":[{"given":"Dominick J.","family":"Casciato","sequence":"first","affiliation":[{"name":"Orlando VA Medical Center, Orlando, FL."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Bischoff","sequence":"additional","affiliation":[{"name":"OhioHealth Grant Medical Center, Columbus, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Barron","sequence":"additional","affiliation":[{"name":"OhioHealth Grant Medical Center, Columbus, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"The Essentials of Charcot Neuroarthropathy: Biomechanics, Pathophysiology, and MRI Findings","author":"Pierre-Jerome C","year":"2022","unstructured":"Pierre-Jerome C: The Essentials of Charcot Neuroarthropathy: Biomechanics, Pathophysiology, and MRI Findings, Elsevier, Cambridge, MA, 2022."},{"key":"B2","series-title":"J Foot Ankle Surg","first-page":"1076","article-title":"Radiodensity analysis of medial column superconstruct fixation sites in midfoot Charcot neuroarthropathy","volume":"61","author":"Casciato DJ","year":"2022","unstructured":"Casciato DJ, Stone R, Thompson J, et al: Radiodensity analysis of medial column superconstruct fixation sites in midfoot Charcot neuroarthropathy. J Foot Ankle Surg 61: 1076, 2022."},{"key":"B3","series-title":"J Foot Ankle Surg","first-page":"377","article-title":"Radiodensity analysis of lateral column superconstruct fixation sites in midfoot Charcot neuroarthropathy","volume":"62","author":"Casciato DJ","year":"2023","unstructured":"Casciato DJ, Stone R, Thompson J, et al: Radiodensity analysis of lateral column superconstruct fixation sites in midfoot Charcot neuroarthropathy. J Foot Ankle Surg 62: 377, 2023."},{"key":"B4","series-title":"J Clin Orthop Trauma","first-page":"59","article-title":"Surgical treatment of midfoot Charcot neuroarthropathy review of literature and our results after superconstruct reconstruction of midfoot Charcot neuroarthropathy","volume":"17","author":"Fr\u00f8kj\u00e6r J","year":"2021","unstructured":"Fr\u00f8kj\u00e6r J: Surgical treatment of midfoot Charcot neuroarthropathy review of literature and our results after superconstruct reconstruction of midfoot Charcot neuroarthropathy. 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J Foot Ankle Surg 57: 1073, 2018."},{"key":"B17","series-title":"JAPMA","first-page":"Article_4","article-title":"Location of the deep plantar artery: a cadaveric study","volume":"110","author":"Whelan JH","year":"2020","unstructured":"Whelan JH, Lazoritz JP, Kiser C, et al: Location of the deep plantar artery: a cadaveric study. JAPMA 110: Article_4, 2020."},{"key":"B18","series-title":"Foot Ankle Int","first-page":"916","article-title":"Anatomic structures at risk when utilizing an intramedullary nail for distal fibular fractures: a cadaveric study","volume":"38","author":"Goss DA Jr","year":"2017","unstructured":"Goss DA Jr, Reb CW, Philbin TM: Anatomic structures at risk when utilizing an intramedullary nail for distal fibular fractures: a cadaveric study. Foot Ankle Int 38: 916, 2017."},{"key":"B19","series-title":"J Foot Ankle Surg","first-page":"687","article-title":"Anatomic structures at risk: curved hindfoot arthrodesis nail: a cadaveric approach","volume":"53","author":"Knight T","year":"2014","unstructured":"Knight T, Rosenfeld P, Jones IT, et al: Anatomic structures at risk: curved hindfoot arthrodesis nail: a cadaveric approach. J Foot Ankle Surg 53: 687, 2014."},{"key":"B20","series-title":"J Foot Ankle Surg","first-page":"2","article-title":"Accuracy of palpation to identify the medial branch of the medial dorsal cutaneous nerve in medial column surgery: correlation of preoperative nerve marking with intraoperative findings during Lapidus fusion","volume":"60","author":"Boffeli TJ","year":"2021","unstructured":"Boffeli TJ, Gervais SJ: Accuracy of palpation to identify the medial branch of the medial dorsal cutaneous nerve in medial column surgery: correlation of preoperative nerve marking with intraoperative findings during Lapidus fusion. J Foot Ankle Surg 60: 2, 2021."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/115\/6\/23-110.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/115\/6\/23-110.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/115\/6\/23-110.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:20:24Z","timestamp":1783506024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/115\/6\/23110"}},"subtitle":["A Cadaveric Study"],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":20,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.7547\/23-110","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}