- 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