Direct Lateral Approach to the Lateral Process of Talus

The lateral approach to the lateral process of talus exposes the posterior facet of the talocalcaneal joint. Because the exposure is through a small window, it is mainly used for fixation of lateral process fractures or debridement of this part of the talocalcaneal joint.

Position of the Patient

Place the patient supine on the operating table with a sandbag under the buttock of the affected side to bring the lateral malleolus forward (Fig. 15-1). After exsanguination, apply a tourniquet to the mid-thigh.

Landmarks and Incision

Palpate the lateral malleolus, located at the subcutaneous distal end of the fibula. The peroneal tubercle is a small protuberance of bone on the lateral surface of the calcaneus that separates the tendons of the peroneus longus and the brevis muscles. It lies distal and anterior to the lateral malleolus and can easily be felt.

Figure 15-1 Place the patient supine on the operating table with a sandbag under the buttock of the affected side to bring the lateral malleolus forward.

Make a 4-cm longitudinal incision from the tip of the lateral malleolus to the peroneal tubercle (Fig. 15-2).

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