– Two Incision Exposure: – prior to open exposure, a markedly displaced frx should be reduced and held in place w/ K wires; – 6-7 cm linear incision beginning 2 cm proximal to Lisfranc joint & extending distally over first intermetatarsal space; – avoid damage to … Read more
– Preoperative Considerations: – radiographs – open ankle fractures – fracture dislocations of the ankle – trimalleolar frx: – in these fractures, consider a posterior approach using an antiglide plate which allows for direct fixation of the posterior mallleolar frx (w/ screws inserted from posterior … Read more
– See: – Anterolateral Approach – Kocher approach – Posterolateral Approach to the Ankle: (Gatellier and Chastang) – Medial Approach to the Ankle – Anterior Approach: – allows acces to medial malleolus & medial articular facet of body of talus – it is used for ankle fusion, anterior … Read more
– See: – Posterolateral Approach – Posterolateral Bone Grafting
– Implant Selection: Osteonics – PreOp Planning: – Patient Positioning: – Anterior Longitudinal Midline Approach: – Synovectomy (if appropriate): – Medial and Lateral Capsular Exposure: – Patellar Eversion: – Articular Exposure: – IM Alignment Rod: – drill is used to enter femoral IM canal just … Read more
– See: – Innervation of the Leg and Foot: – Sural Artery: – Medial sural cuteus nerve: – tibial nerve just below knee joint gives rise to medial sural cutaneous nerve, which runs downward across union of heads of gastronemius; – it is joined … Read more
– Surgical Anatomy of Clubfoot: – contractures of ankle, subtalar, talonavicular, & calcaneocuboid joints; – forepart of foot is adducted & hind part of the foot is in varus angulation; – talus: – lies in a position of equinus, & its head is palpable … Read more
– See: anterolateral approach to the ankle – Anatomy: – peroneus brevis is anterior to peroneus longus at level of ankle joint and is closer to lateral malleolus; (brevis is muscular almost down to the ankle); – flexor hallucis longus is most lateral of deep flexor muscles … Read more
– Incision: – although the closed reduction may require external rotation of the hip, the initial incision is facilitated w/ slight internal rotation of the leg; – make straight lateral incision two finger breadths below the vastus ridge to a point 5-7 cm distally; – typically the … Read more
– Discussion: – when viewed in cross section, shape of distal femur resembles trapezoid w/ medial side inclinded about 25 deg & lateral side about 10 deg; – both the seating chisel and the subsequent blade plate should be 1 cm to 2 cm short of medial cortex … Read more