OrthoNet

Talocalcaneal joint - lateral approach

* position - supine with sandbag under buttock & table tilted 20-30 deg. away from surgeon

* incision
- curved incision 10-13 cm long on lat. aspect of ankle starting 4 cm above tip of lat. malleolus on post. border of fibula
- follow to tip of fibula & curve forward passing over peroneal tubercle parallel to course of peroneal tendons

* no internervous plane

* dissection
- avoid sural n. & short saphenous vein as they run just post. to lat. malleolus
- incise deep fascia in prox. wound to expose peroneal tendons
- continue to incise fascia following tendons
- incise inf. peroneal retinaculum in line with PB
- incise fibrous sheath over PL
- retract peroneal tendons ant.
- ID calcaneofibular lig. running from lat. malleolus to lat. surface of calcaneus
- ID subtalar joint & incise capsule

* dangers
- sural n. & short saphenous vein