Approach to the Fibula

Incision along the anterior border of the fibula, with the peroneal muscles retracted posteriorly and the peroneus tertius and extensor digi — Incision along the anterior border of the fibula, with the peroneal muscles retracted posteriorly and the peroneus tertius and extensor digitorum retracted anteriorly to expose the fibula. Image from Mishra J, Kumar Das T, Guglani K, Behera S, Zion N, Biradar P. Single-Incision Direct Lateral Approach Versus Dual-Incision Approach for Distal Tibial and Fibular Fractures. Cureus. 2024, 16(9), e69516. CC BY 4.0.

Approach to the Fibula, peroneus longus, from gray’s anatomy — Peroneus longus, from Gray’s Anatomy. Image by Henry Vandyke Carter, Wikimedia Commons, Public domain.

Position

supine or prone
pad bony prominences

Landmarks

head of fibula
shaft of fibula

Incision

straight longitudinal incision just posterior to fibula
Start: lateral malleolus
End: fibula head

Internervous Plane

Peroneal muscles
- Superficial peroneal nerve
Flexor muscles
- Tibial nerve

Superficial Dissection

Proximally
- Incise fascia
- Taking care not to damage
  - Common peroneal nerve
- Identify biceps femoris tendon
  - CPN is posterior to it
Identify & develop the plane between peroneal muscles & soleus

Deep Dissection

Subperiosteally
- Reflect muscle attachments

Dangers

Nerves
- Common peroneal nerves
Vessels
- Terminal branches of peroneal artery near lateral malleolus

Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.