Approach to the Fibula

Position

• supine or prone
• pad bon 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