The Knee: Reconstruction, Replacement  and Revision Tracking Pixel
Duke Orthopaedics
presents
Wheeless' Textbook of Orthopaedics

Posterolateral Approach to the Ankle



- Discussion:
    - allows access for ORIF of fractures of ankle w/ frx of posterior tibial lip;
    - allows access for removal of osteochondritis dissecans fragments from lateral part of dome of talus and for osteochondromatosis of ankle;
- Incision:
    - begin incision about 12 cm proximal to tip of lateral malleolus & extend it distally along posterior margin of fibula to tip of malleolus;
    - curve incision anteriorly for 2.5-4 cm in line of peroneal tendons;
    - expose fibula including lateral malleolus subperiosteally;
    - incise peroneal tendon sheaths & retract them anteriorly;
    - fibular osteotomy
          - if fibula is intact, transect it about 10 cm proximal to tip of lateral malleolus;
          - free distal fragment by dividing the interosseous membrane and anterior and posterior malleolar ligaments;
          - carefully preserve calcaneofibular and talofibular ligaments to serve as a hinge and to maintain the integrity of ankle after operation;
          - turn the fibula laterally on this hinge, and expose lateral & posterior aspects of distal tibia & lateral aspect of ankle joint



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

Last updated by Data Trace Staff on Monday, August 13, 2012 3:57 pm