OrthoNet

Ankle - anterior approach

* position - supine with tourniquet

* incision - long. incision over ant. ankle halfway btw malleoli

* no internervous plane - use intermuscular plane btw EHL & EDL

* dissection
- incise fascia in line with skin
- ID interval btw EHL & EDL
- find nv bundle just med. to EHL
- follow nv bundle distally to ankle until it crosses behind EHL
- mobilize nv bundle
- incise remaining soft tissue on ant. tibia to expose tibia & ankle joint
- subperiosteal dissection of distal tibia

* dangers
- SPN - run close to line of incision just under skin
- DPN & ATA
> above ankle - btw EHL & TA
> distal to ankle - btw EHL & EDL
> crosses post. to EHL at level of ankle