Anterolateral Approach to the Ankle   



- Discussion:
    - allows acces to ankle joint, talus, & other tarsal bones and joints;
    - it does not allow access to the navicular and 2nd and 1st cuniforms;
    - avoids all of the important vessels and nerves;
    - dissection procedes between the peroneus tertius (deep peroneal nerve) and the peroneus brevis (superficial peroneal nerve);

- Incision:
    - begin the incision over anterolateral aspect of the leg, medial to fibula and 5 cm proximal to the ankle joint;
    - continue incision distally to cross over talus, calcaneocuboid joint;
    - end incision at the base of 4th metatarsal;
    - dissection usually divides anterolateral malleolar & lateral tarsal arteries;
    - identify & protect intermediate dorsal cutaneous branch of the superficial peroneal nerve;
    - divide origin of EDB and reflect it distally;
    - retract the extensor tendons, the dorsalis pedis artery, and the deep peroneal nerve medially, and incise the capsule



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, August 13, 2012 3:56 pm