Tuber-to-Anterior Process Angle (TAPA): A cadaveric study and surgical technique for placing axial calcaneal screws

•We describe a simple technique that facilitates the placement of axial calcaneal screws.•The Tuber-to-Anterior Process Angle (TAPA) describes the calcaneal long-axis as it relates to the long-axis of the foot.•The TAPA is approximately 10 degrees laterally deviated from the long-axis of the foot.•K...

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Bibliographic Details
Published in:Injury 2019-07, Vol.50 (7), p.1398-1403
Main Authors: Stupay, Kristen L., Briceño, Jorge, Velasco, Brian T., Miller, Christopher P., Kwon, John Y.
Format: Article
Language:English
Subjects:
Axial calcaneal screws
Bone Screws
Cadaver
Calcaneus - surgery
Fluoroscopy
Foot - anatomy & histology
Foot - surgery
Fracture Fixation, Internal - methods
Humans
Reproducibility of Results
Screw placement
Technical tip
Tuber-to-Anterior Process Angle
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Summary:•We describe a simple technique that facilitates the placement of axial calcaneal screws.•The Tuber-to-Anterior Process Angle (TAPA) describes the calcaneal long-axis as it relates to the long-axis of the foot.•The TAPA is approximately 10 degrees laterally deviated from the long-axis of the foot.•Knowledge of this angle simplifies placement of P:A screws in the calcaneus.•Understanding this relationship reduces reliance on intraoperative axial fluoroscopy and increases operative efficiency. We describe results of a cadaveric study and an accompanying surgical technique which simplifies posterior-to-anterior axial screw placement into the calcaneus, often utilized during fixation of displaced intra-articular calcaneus fractures or calcaneal osteotomies. By defining the Tuber-to-Anterior Process Angle (TAPA), this technique facilitates axial screw placement, thereby decreasing reliance on intraoperative fluoroscopy and reducing operative time.
ISSN:0020-1383
1879-0267
DOI:10.1016/j.injury.2019.05.019