OrthoNet

Ankle - posteromedial approach

* position
- supine with hip flexed & ER and knee flexed
- lateral with affected leg down

* incision - long. incision midway btw Achilles tendon & med. malleolus

* no internervous plane

* dissection
- deepen incision to enter fat that lies btw Achilles & flexor tendons
- ID fascia in ant. flap that covers flexor tendons

> first
- ID FHL
- develop plane btw FHL & peroneal tendons
- expose ankle joint & incise capsule

> second
- ID FHL
- continue dissection ant. toward med. malleolus
- ID nv bundle & retract lat. with FHL
- develop plane btw nv bundle & FDL
- expose ankle & incise capsule

* dangers
- PTA & tibial n. - run btw FDL & FHL with art. ant. to nerve