Hindfoot – Lateral Approach

Hindfoot – lateral approach

* position – supine with sandbag under buttock

* incision
– curved, transverse incsion starting just distal to distal end of lat. malleolus
– continue distally over lat. side of hindfoot & over sinus tarsi
– curve med. to end over talocalcaneonavicular joint

* internervous plane – peroneus tertius (DPN) & peroneal tendons (SPN)

* dissection
– don’t mobilize skin flaps widely — at risk of necrosis
– incise deep fascia in line with skin
– avoid tendons of peroneus tertius & EDL
– retract PT & EDL med.
– detach fat that lies in sinus tarsi
– detach origin of EDB from calcaneus
– expose dorsal capsule of talocalcaneonavicular joint in distal end of wound
– expose dorsal capsule of calcaneocuboid joint lat.
– incise peroneal retinacula & reflect peroneal tendons ant.
– incise capsule of post. talocalcaneal joint

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