Access Keys:
Skip to content (Access Key - 0)

Anteromedial approach to medial malleolus

Invalid License

License is not configured.

Introduction

  • Allows inspection of the anteromedial ankle joint and the anteromedial part of the dome of the talus

Indications

  • Used mainly for ORIF of the medial malleolus

Position of patient

  • The patient is placed supine on the operating table

Landmarks and incision

Landmark
  • Identify the anterior and the posterior borders of the medial malleolus
Incision
  • A 10-cm longitudinal curved incision, with its midpoint just anterior to the tip of the medial malleolus
  • Begin proximally 5 cm above the malleolus and over the middle of the subcutaneous surface of the tibia, crossing the anterior third of the medial malleolus
  • The incision is curved forward to end 5 cm anterior and distal to the malleolus

Internervous plane

  • No internervous plane.

Superficial dissection

  • Widen the skin flaps
  • Identify the long saphenous vein and the accompanying saphenous nerve, which lie just anterior to the medial malleolus

Deep dissection

  • Incise the remaining coverings of the medial malleolus longitudinally to expose the fracture site
  • Make a small incision in the anterior capsule of the ankle joint to see the articulating surface
  • Split the superficial fibers of the deltoid ligament, which run anteriorly and distally downward from the medial malleolus, so that wires or screws will be anchored solidly on bone

Dangers

  • Preserve the saphenous nerve by preserving the long saphenous vein
  • The long saphenous vein is at risk when the anterior skin flaps are mobilized

How to enlarge the approach

Proximal

  • Incision can be extended along the subcutaneous surface of the tibia

Distal

  • Incision can be extended to expose the deltoid ligaments and the talocalcaneonavicular joint

Figures

Peer Review

OrthopaedicsOne Peer Review Workflow is an innovative platform that allows the process of peer review to occur right within an OrthopaedicsOne article in an open, transparent and flexible manner. Learn more

Instructions for Authors

Read our Instructions for Authors to learn about contributing or editing articles on OrthopaedicsOne.

Content Partner

Learn about becoming an OrthopaedicsOne Content Partner.

Academic Resources

Resources on Anteromedial approach to medial malleolus from Pubget.

The license could not be verified: License Certificate has expired!
Orthopaedic Web Links

Internet resources validated by OrthopaedicWebLinks.com

The license could not be verified: License Certificate has expired!
Related Content

Resources on Anteromedial approach to medial malleolus and related topics in OrthopaedicsOne spaces.

Page: Posteromedial approach to medial malleolus (OrthopaedicsOne Articles)
Page: Anteromedial approach to medial malleolus (OrthopaedicsOne Articles)
Page: Lateral approach to lateral malleolus (OrthopaedicsOne Articles)
Page: Surgical approaches in a nutshell (OrthopaedicsOne Articles)
Page: Retroperitoneal approach to the lumbar spine (OrthopaedicsOne Articles)
Page: Posterior approach to the lumbar spine (OrthopaedicsOne Articles)
Page: Posterior approach to the cervical spine (OrthopaedicsOne Articles)
Page: University of Iowa Foot and Ankle Fellowship (OrthopaedicsOne Fellowships)
Page: Fixing the Difficult Ankle Fracture - Tips and Tricks (OrthopaedicsOne Articles)
Page: Ankle Fracture Complications - Salvaging a Failed ORIF (OrthopaedicsOne Articles)
Showing first 10 of 187 results