Ankle – Anterior Approach

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