Talocalcaneal Joint – Lateral Approach

Talocalcaneal joint – lateral approach

* position – supine with sandbag under buttock & table tilted 20-30 deg. away from surgeon

* incision
– curved incision 10-13 cm long on lat. aspect of ankle starting 4 cm above tip of lat. malleolus on post. border of fibula
– follow to tip of fibula & curve forward passing over peroneal tubercle parallel to course of peroneal tendons

* no internervous plane

* dissection
– avoid sural n. & short saphenous vein as they run just post. to lat. malleolus
– incise deep fascia in prox. wound to expose peroneal tendons
– continue to incise fascia following tendons
– incise inf. peroneal retinaculum in line with PB
– incise fibrous sheath over PL
– retract peroneal tendons ant.
– ID calcaneofibular lig. running from lat. malleolus to lat. surface of calcaneus
– ID subtalar joint & incise capsule

* dangers
– sural n. & short saphenous vein