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Anterolateral Approach to Ankle Joint

 Anterolateral Approach to Ankle Joint

Anterolateral Approach to Ankle Joint indications:

The full extent of the anterolateral approach to the ankle and hindpart of the foot allows exposure not only of the ankle joint, but also of the talonavicular, calcaneocuboid, and talocalcaneal joints.

The anterolateral approach to ankle joint is used to:

  1. Open reduction and internal fixation of pilon fractures.
  2. Reduce the talus in cases of talar dislocation.
  3. Open bone biopsy.
  4. Access to the anterior ankle joint for debridement.
  5. Triple arthrodesis.
See Also: Ankle Anatomy

Position of the Patient

Place the patient supine on the operating table; place a large sandbag underneath the affected buttock to rotate the leg internally and bring the lateral malleolus forward.

Landmarks and Incision

Landmarks:

  1. Lateral malleolus.
  2. Base of the fifth metatarsal

Incision:

Anterolateral Approach to Ankle Joint

Internervous plane

The internervous plane for the anterolateral approach to ankle joint lies between:

  1. The peroneal muscles which are supplied by the superficial peroneal nerve.
  2. The extensor muscles which are supplied by the deep peroneal nerve.

Superficial dissection

Deep dissection

Approach Extension

Proximal extension:

The Anterolateral Approach to Ankle Joint can be extended proximally to explore structures in the anterior compartment of the leg.

Continue the incision over the compartment, and incise the thick deep fascia in line with the skin incision.

Distal extension:

The Anterolateral Approach to Ankle Jointalso can be extended distally to expose the tarsometatarsal joint on the lateral half of the foot.

Continue the incision over the fourth metatarsal, and expose the subcutaneous tarsometatarsal joints.

Dangers

The structures at risk during anterolateral approach to ankle joint include:

  1. Superficial peroneal nerve.
  2. Deep peroneal nerve.
  3. Anterior tibial artery.

References


Learn More Orthopedic

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