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Incision for Triple Arthrodesis


- Discussion:
    - mark out base of 5th metatarsal and tip of lateral malleolus;
    - select point halfway between the two and make an oblique incision which parallels subtalar joint line over sinus tarsi; (see Ollier Incision);
    - avoid the sural nerve which lies 1-2 cm beneath the distal tip of the fibula;
    - avoid cutting toe extensors which lie anterior and peroneal tendons which lie posterior;
          - open the peroneal tendon sheath and expose the brevis tendon;
          - partially open the extensor tendon sheath;
    - lateral incision is longitudinal and placed on line drawn connecting points between tip of lateral malleolus to base of 4th metatarsal;
          - this approach has avoids injury to superficial peroneal and sural nerves than Ollier incision;
          - in distal 1-2 cm of incision, branch of sural nerve is identified