Updated: 12/6/2015

Tibia Anterior Approach

Review Topic
  • Provides safe exposure to
    • medial (subcutaneous) border of the tibia
    • lateral (extensor) surface of the tibia
    • preferred approach to tibia unless the skin is compromised
  • Indications
    • ORIF of tibia fractures
    • bone grafting for nonunion or delayed union
    • implantation of electrical stimulators
    • excision or biopsy of bone lesions
    • osteotomy
Internervous Plane
  • None
    • dissection carried epi-periosteal between tibialis anterior and tibia
  • Anesthesia
    • general 
    • sciatic or saphenous nerve blocks
  • Position
    • supine
  • Tourniquet
    • exsanguinate limb
  • Incision
    • make a longitudinal incision 1 cm lateral to the anterior border of tibia 
    • length of incision depends on procedure, but the tibia may be exposed along its entire length
  • Superficial dissection
    • elevate skin flaps to expose the medial (subcutaneous) border of the tibia
    • be sure to protect the long saphenous vein when retracting the skin flaps
  • Deep dissection 
    • medial subcutaneous surface
      • essential to minimize subperiosteal stripping
      • incise periosteum longitudinally along the middle of the medial border
      • reflect the periosteum anteriorly and posteriorly
    • lateral extensor surface
      • incise periosteum over anterior border of the tibia
      • subperiostally dissect the tibialis anterior and neurovascular bundle and retract laterally

    Clinical Images
Structures at Risk 
  • Long Saphenous Vein
    • is on medial side of calf and should be protected when raising  a medial skin flap

Please rate topic.

Average 3.0 of 4 Ratings

Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine

The complexity of this topic is appropriate for?
How important is this topic for board examinations?
How important is this topic for clinical practice?
Topic COMMENTS (2)
Private Note