
21/02/2025
Id like to share a VuMedi talk on PASTARA - Posterior Arthroscopic Subtalar and Ankle joint Rod Arthrodesis for elderly and or neuropathic ankle fractures
PASTARA is the technique indicated for patients with Non Ambulatory Fragility Ankle Fractures (NAFF) with soft tissue envelope compromise. Key aspects:
- NAFF ankle fractures should be treated with 36 hours from presentation
- Perform surgery with aim to allow immediate unrestricted weight bearing (GIRFT)
- Use PASTARA technique (10:40) for elderly (over 65 and or severely comorbid) patients with
- severe soft tissue envelope compromise (blisters, severe swelling, skin atrophy)
- Consider this technique for patients with severe joint destruction, neuropathy,
Technical tips
- Arthroscopic portals at extended STJ and Ankle joint line crossing points
- Hoke Tripple Achilles Hemisection to allow immediate unrestricted patients
- aim to fuse in about 3 degrees dorsiflexion
- aim for tibial isthmus fitting intramedullary hindfoot nail (wide diameter and sufficient length)
- use anterior calcaneotibial miss a nail screw
- apply back and U slab
- complete weight bearing cast next day
dchlebinskas.com
https://www.vumedi.com/video/pastara-posterior-arthroscopic-subtalar-and-ankle-rod-arthrodesis-for-geriatric-or-neuropathic-ankle