Lateral Ankle Ligament Repair
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Place the patient in the supine position with a bump under the ipsilateral iliac crest to internally
rotate the foot. Alternatively, the patient can be placed in a semi-lateral position with a
deflatable beanbag device. Make a longitudinal incision centered over the distal fibula and
curving anteriorly past the fibula. Alternatively, a five to six cm curvilinear incision can be made
along the anterior and inferior border of the lateral malleolus.
Dissect the subcutaneous tissues down to the level of the fibular periosteum, the anterior
talofibular ligament (ATFL), and the inferior extensor retinaculum (A). If there is concern for
peroneal tendon pathology, the peroneal tendons can be inspected at this point by making a
longitudinal incision in the peroneal tendon sheath just posterior to the fibula. Use blunt
dissection anteriorly to ensure that the superficial peroneal nerve is not trapped in the soft-
tissues that will be used for the repair (B).
A
B
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