Ankle – Medial Approach

Ankle – medial approach

* position – supine with tourniquet

* incision – long. incision centered on tip of medial malleolus, curve forward onto medial side of middle part of foot

* no internervous plane

* dissection
– mobilize skin flaps
– avoid long saphenous vein & saphenous n.
– ID where med. malleolus joins shaft of tibia & make small long. incision in ant. joint capsule
– divide flexor retinaculum & ID TP tendon
– retract TP post.
– expose post. surface of med. malleolus
– score med. malleolus long.
– drill & tap med. malleolus
– using oscillating saw, ostotomize med. malleolus from sup. to inf.
– reflect med. malleolus inf. with deltoid attachment
– evert foot to bring dome of talus into view

* dangers
– saphenous n. & long saphenous vein – run just ant. to med. malleolus
– TP – lies just post. to med. malleolus