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Flashcards in anterior approach to ankle Deck (9)
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1
Q

What is the indications for this approach?

A

Pilon ankle fracture
Ankle fusion
I&D of ankle

2
Q

What is the intermuscular plane?

A

Between
EXT HALLUCIS LONGUS
EXT DIGITORIUM LONGUS
Both supplied by DEEP PERONEAL N

3
Q

What would the pt set up be?

A

Spinal/GA

Partial exsangination of leg - better visualisation of neurovascular bundle

4
Q

Describe the incision ?

A

Make 15cm incision Midpoint of the ankle between malleoli
start proixmal
Stay superificial to avoid damage to branches of SUPERFIICAL PERONEAL N

5
Q

Describe the supericial dissection?

A

Incise FASCIA in line with skin incision
Incise EXTENSOR RETINACULUM
FInd division betwenn EHL and EDL above ankle
Identify tje NV bundle- deep peromeal nerve and ant tibial artery
retract EHL and NV bundle- MEDIALLY
Retract EDL LATERALLY

6
Q

Describe the deep dissection?

A

Incise capsule to enter joint

reveal talus and tibia by superiosteal and capsular release

7
Q

Describe the medial variation in dissection?

A

INCISE THE SKIN 15CM ANT TO MEDIAL MALL
INCISE DEEP FASCIA MEDIAL TO TIBIALIS ANT TENDON
RETRACT TIBAILIS ANT TENDON LATERALLY TO EXPOSE JOINT

8
Q

What are the dangers with this approach?

A

CUTANEOUS BRANCHES OF SUPERFICIAL PERONEAL N- greatest danger during skin incision
nV bundle- DEEP PERONEAL N AND ANT TIBIAL ARTERY

9
Q

Where does NV bundle cross?

A

Behind EHL at ankle joint