Open procedures

Surgical Procedure

Curved incision crossing the tip of the lateral malleolus
Dissect towards the extensor digitorum muscle
With the ankle in dorsiflexion, incise the fascia to disclose the muscle belly
Create arthrotomy by removing a part of the joint capsule
Open the sheet of the peroneal tendons distal to the tip of the lateral malleolus
Overview
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Pearls & Pitfalls

1. Use resorbable sutures. The time to resorption of the sutures is long enough to heal the reconstruction. In addition, unresorbable sutures can cause irritation.


2. Tighten the sutures with the foot in eversion. Since it is an anatomical reconstruction, it can never be too tight.


3. Laxity can remain when the sutures are initially knotted at the posterior tip of the fibula. To secure a tight reconstruction, pull the ligament remnants tight over the denuded fibula tip (picture)

llr13

Pull the ligament remnants tight over the denuded fibula tip to secure the reconstruction. A tight reconstruction has been achieved

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