OrthoNet

Tibia - anterolateral approach

* position - supine with sandbag under buttock or lateral with tourniquet

* incision - long. incision overlying shaft of fibula

* internervous plane
- superficial - peroneus brevis (SPN) & EDL (DPN)
- deep - tibialis post. (tibial n.) & extensor muscles of ankle/foot (DPN)

* dissection
- deepen incision
- beware of lesser saphenous vein
- incise fascia in line with skin incision
- develop plane btw PB & EDL
- protect SPN which lies on PB
- detach extensor muscles from ant. aspect of interosseous membrane
- follow ant. aspect of membrane onto tibia
- straying ant. may cause damage to ant. nv bundle
- expose posterolat. corner of tibia
- strip off small portion of tib. ant. from lat. aspect of tibia

* dangers
- lesser saphenous vein
- SPN - lies on PB
- ATA & DPN - run down leg in ant. compartment just ant. to interosseous membrane