Fibula – Approach

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