Introduction Provides exposure to entire fibula Indications include ORIF of fibula fractures resection of fibula excision of fibula bone lesions Internervous plane Between peroneal muscles (superficial peroneal nerve) muscles of the posterior compartment (tibial nerve) Approach Position may be done supine with bump under affected limb or in lateral position Incision Make linear longitudinal incision along the posterior border of the fibula (length depends on desired exposure) may extend proximally to a point 5cm proximal to the fibular head proximally follow in line with the biceps femoris tendon Superficial dissection begin proximally and incise the fascia taking great care not to damage the common peroneal nerve identify the posterior border of the biceps femoris tendon and its insertion into the head of the fibula about 10-12 cm above the tip of the lateral malleolus, the superficial peroneal nerve pierces the fascia identify and isolate the common peroneal nerve as it courses behind the biceps femoris tendon mobilize the common peroneal nerve by cutting the fibers of the peroneus longus Deep dissection develop plane between peroneal muscles and soleus down to bone make a longitudinal incision in the periosteum of the fibula strip the muscles that originate on the fibula to expose your desired segment of fibula Extensile measure distal - may be extended distally to become continuous with Approach to the lateral malleolus Ollier's lateral approach to the tarsus Kocher lateral approach to the ankle and tarsus Lateral approach to the calcaneus Dangers Common peroneal nerve avoid injury by isolating proximally Superficial peroneal nerve susceptible to injury at junction of middle and distal third of leg if injured will cause numbness on the dorsum of the foot