Hello Surgeon 👋🏻

X

How can we help you today?

Ollier Approach to Sinus Tarsi

 Ollier Approach to Sinus Tarsi


Ollier Approach indications:

The Ollier approach is excellent for a triple arthrodesis, where the three joints are exposed through a small opening without much retraction, and the wound usually heals well because the proximal flap is dissected full thickness and the skin edges are protected during retraction.

Position of the Patient

The patient is positioned Supine with bump under buttock.

Landmarks and Incision

  • Make a 8-10 cm curved incision:
  • Begin incision over dorsal-lateral talonavicular joint.
  • Extend posteriorly over the sinus tarsi (soft tissue depression just anterior to lateral malleolus).
  • Incise obliquely to point 2.5 cm below tip of lateral malleolus.
Ollier Approach to the Tarsus

Internervous plane

The Internervous plane for Ollier Approach lies between:

  • Peroneus tertius muscle: which is innervated by the deep peroneal nerve.
  • Peroneus brevis muscle: which is innervated by the superficial peroneal nerve.

Superficial dissection

  • Incise fascia and divide inferior extensor retinaculum in line with incision.
  • Ligate veins crossing operative field.
  • Mobilize small flaps (large flaps may necrose).
  • Incise deep fascia and extensor retinaculum in line with incision: careful not to damage peroneus tertius and extensor digitotum longus.
  • In the superior (distal) part of the incision expose peroneus tertius and EDL and retract medially.
  • In inferior part of incision expose peroneal tendons and retract inferior.

Deep dissection

  • Partially resect fat pad over sinus tarsi with sharp dissection (leave attached to skin flap).
  • Identify and detach origin of extensor digitorum brevis under fat pad.
  • Reflect extensor digitorum brevis distally.
  • Identify and incise dorsal capsule of talocalcaneonavicular joint.
  • Identify and incise capsule of calcaneocuboid joint.
  • Incise peroneal retinacula and reflect peroneal tendons anteriorly.
  • Identify and incise capsule of posterior talocalcaneal joint.

Dangers

The structures at risk during The Ollier approach include:

  1. Skin flap necrosis: keep skin small and thick and avoid sharp curves.
  2. Extensor digitorum longus tendon.
  3. Peroneus brevis tendon.

References

  • Campbel’s Operative Orthopaedics book 12th

Learn More Orthopedic

 Wrist Arthroscopy

Wrist Arthroscopy

Wrist arthroscopy allows close visual examination of the carpal articular surfaces and wrist ligaments, which is…
 Elbow Arthroscopy

Elbow Arthroscopy

Elbow arthroscopy is a useful tool in the treatment of simple and complex disorders of the…
 Posterior Approach to the Humerus

Posterior Approach to the Humerus

The midline posterior approach to the humerus is classically extensile, providing excellent access to the lower…
 Posterior Approach to the shoulder

Posterior Approach to the shoulder

The posterior approach to the shoulder (Judet Approach) offers access to the posterior and inferior aspects…
 Deltopectoral Approach to the Shoulder

Deltopectoral Approach to the Shoulder

The deltopectoral approach to the shoulder offers good wide exposure joint, allowing repairs to be made…
 Anteromedial Approach to Ankle Joint

Anteromedial Approach to Ankle Joint

The Anteromedial Approach to Ankle Joint is used for open reduction and internal fixation of medial…


Get Orthopedic apps for android

orthopedic examination and special test app for android