Ankle fusion - The distal tibial cut 2
To ensure adequate visualisation for the distal tibial cut a large bone lever (2) is used to elevate the anterior soft tissue envelope. The cut needs to be at 90 degrees to the long axis of the tibia in both saggital and coronal planes to place the ankle fusion in a functional position. To ensure correct alingment in the coronal plane a second skin incision is needed medially. This is in the line of tibialis anterior tendon and the medial joint and malleolus need to be exposed.