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Medial utility incision

Additional dorsomedial incision

If there is a navicular fracture with comminution and loss of the architecture of the navicular part of the talo-navicular joint, then a dorsomedial incision may be used to properly reconstruct the shape of the navicular.
If fracture care requires a more extensile approach, the advantages of better reduction are balanced against wider dissection causing stripping/loss of blood supply which may impede healing. If the dorsomedial approach is required, care should be taken to minimize dissection.
For details of the dorsomedial approach, click here.