Indications Calcaneus fractures Incision Begin 2.5 anterior and 4cm distal to medial malleolus carry the incision posteriorly along the medial surface of the foot to visualize the sustentaculum, the inicision should be 5 cm long following the neurovascular structures identify the posterior tibial tendon, the neurovascular bundle and the flexor hallucis tendon Develop the interval between the neurovascular bundle and the flexor hallucis tendon Incise the retinaculum feel for the bump of the sustentaculum this is immediately above the flexor hallucis tendon Deep Dissection Divide the fat and fascia to define the inferior margin of abductor hallucis Define the inferior margin of the abductor hallucis Mobilize the muscle belly retract it dorsally this exposes the medial and inferomedial aspects of the body of the calcaneus Continue the dissection distally by dividing the plantar aponeurosis and the muscles attaching to the calcaneus Subperiostally strip muscle and plantar aponeurosis off the medial and inferior calcaneus Dangers Medial calcaneal nerve Nerve to abductor digiti minimi