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Lateral approach

General considerations

The longitudinal lateral incision is the standard approach for most lateral fractures.

If a lateral plate is required for the lateral malleolus, the incision should be placed either slightly anteriorly or posteriorly, so that the plate does not come to lie directly beneath the incision.

If a posterior plate is planned, place the incision slightly posteriorly, so that the soft-tissue dissection can be minimized.

If access to the anterior syndesmosis is required, or a lag screw from anterior to posterior (Chaput lesion) is planned, place the incision slightly anteriorly.

Make a 10-15 cm incision in line with the fibula, starting proximally. If necessary, continue distally a further 2 cm, curving slightly, anteriorly in relation to the tip of the lateral malleolus, in order to increase exposure and release tension.