Anterior approach to the Tibia

Position

supine

Landmarks

shaft of tibia

Incision

straight longitudinal incision on anterior surface of leg
parallel & 1cm lateral to anterior border of tibia

Internervous Plane

Subperiosteal plane

Superficial Dissection

Elevate the skin flaps to expose the subcutaneous surface of tibia
Taking care not to damage
- Long saphenous vein on medial side of calf

Deep Dissection

Two surfaces can be approached
- Subcutaneous medial surface
  - Incise periosteum longitudinally in the middle of the subcutaneous surface
  - Reflect it anterior & posteriorly
- Lateral Extensor surface
  - Incise the periosteum longitudinally over the anterior border of tibia
  - Subperiosteally, reflext tibialis anterior laterally