Posteromedial approach to Ankle

Indications

club foot
exploration of soft tissues around back of malleolus

Position

supine
leg flexed & externally rotated to expose medial side of ankle
tilt table

Landmarks

medial malleolus
achilles tendon

Incision

10 cm longitudinal incision midway between medial malleolus & achilles tendon

Superficial Dissection

subcutaneous fat
fascia
identify achilles tendon

Deep Dissection

3 ways to approach back of ankle
- between FHL & peroneal tendons
- between FHL & FDL
- between medial malleolus & tibialis posterior & FDL

Dangers

Nerves
- Posterior tibial artery & nerve
Vessels