Tibia – Anterolateral Approach

Tibia – anterolateral approach

* position – supine with sandbag under buttock or lateral with tourniquet

* incision – long. incision overlying shaft of fibula

* internervous plane
– superficial – peroneus brevis (SPN) & EDL (DPN)
– deep – tibialis post. (tibial n.) & extensor muscles of ankle/foot (DPN)

* dissection
– deepen incision
– beware of lesser saphenous vein
– incise fascia in line with skin incision
– develop plane btw PB & EDL
– protect SPN which lies on PB
– detach extensor muscles from ant. aspect of interosseous membrane
– follow ant. aspect of membrane onto tibia
– straying ant. may cause damage to ant. nv bundle
– expose posterolat. corner of tibia
– strip off small portion of tib. ant. from lat. aspect of tibia

* dangers
– lesser saphenous vein
– SPN – lies on PB
– ATA & DPN – run down leg in ant. compartment just ant. to interosseous membrane