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Tibia & Fibula

Make a curved incision on either side of the anterior border of the bone; reflect the skin and incise and elevate the periosteum over the desired area. Strip the periosteum as little as possible because its circulation is a source of nutrition for the bone.

The tibia is a superficial bone and can be easily exposed anteriorly without damaging any important structure except the tendons of the tibialis anterior and extensor hallucis longus muscles, which cross the tibia anteriorly in its lower one fourth.

Make a longitudinal incision along the posteromedial border of the tibia. Incise the subcutaneous tissues and deep fascia and then reflect the periosteum from the posterior surface for the required distance.

In some delayed unions and nonunions, Phemister inserted a bone graft in a bed prepared on the posterior surface of the tibia.


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