OrthoNet

Fibula - approach

* position - supine with sandbag under buttock or lateral

* incision - long. incision just post. to fibula beginning behin lat. malleolus & extending to level of fibular head

* internervous plane - peroneal muscles (SPN) & flexor muscles (tibial n.)

* dissection
- find post. border of BF as it sweeps down past knee before inserting on head of fibula
- incise fascia & ID CPN
- trace course of CPN as it winds around fibular neck
- mobilize CPN from groove on back of neck
- develop plane btw PL & soleus
- incise periosteum of fibula
- strip muscle off fibula
- strip interosseous membrane subperiosteally from prox. to distal

* dangers
- CPN - winds around neck of fibula
- dorsal cut. branch of SPN - ID at jxn of distal & middle 1/3 of fibula
- peroneal art. - terminal branches lie close to deep surface of lat. malleolus
- lesser saphenous vein