The lateral approach to the hindfoot (Ollier) is an oblique incision over the sinus tarsi giving access to the subtalar, talonavicular and calcaneocuboid joints. It is used for triple arthrodesis and subtalar fusion, protecting the sural nerve and peroneal tendons.
Indications
- Exposure to
- Subtalar
- Calcaneocuboid joints
- Talonavicular
- Triple arthrodesis
Position
- supine on operating table
- large sandbag under buttock to internally rotate the leg
- elevate & inflate tourniquet
Landmarks
- lateral malleolus
- lateral wall of calcaneus
- sinus tarsi
- just anterior to lateral malleolus
Incision
- curved incision
- Start:
- just distal to the distal end of lateral malleolus
- Continued over the lateral border of the foot & sinus tarsi
- End:
- curving medially & ending over the talonavicular joint
Internervous Plane
- Peroneus tertius
- Peroneal tendon
Superficial Dissection
- Incise down to fascia without developing skin flaps
- Ligate any veins that cross the operative field
- Open the deep fascia in line with skin incision
- Taking care not to damage
- Tendons of
- Peroneus tertius
- Extensor digitorum longus
- Tendons of
- Retract these tendons medially to gain access to the dorsum of the foot
Deep Dissection
- Reflect distally the fat pad overlying the sinus tarsi by sharp dissection leaving it attached to the skin flap
- Detach the origin of FDB which lies underneath to expose the capsule of TN & CC joints
- Perform capsulotomy to expose these joints
- Incise peroneal retinacula & reflect the tendons anteriorly
- Expose the capsule of the subtalar joint which I would incise
Dangers
- Skin Flaps
- thick
- Nerves
- Vessels
Reviewed by Professor Phong Tran, Head of Orthopaedic Surgery, Western Health. Last updated 10 October 2026.