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CHAPTER 30
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The Child with a Limb Deficiency
FIGURE 30-11.
Next, the dorsal incision is deepened through the subcutaneous tissue. The dorsalis pedis vessels are
identified and cauterized, and all the tendons and nerves are pulled distally, sectioned, and allowed to retract proximally.
This exposes the anterior ankle joint, which is now cut open completely. Working carefully between the talus and the
medial malleolus, the deltoid ligament is cut, freeing the medial aspect of the ankle joint. Care is necessary here to avoid
damage to the posterior tibial artery and vein. Working on the lateral side of the ankle, the surgeon cuts the tibiofibular
ligaments. The only remaining portion of the ankle capsule remaining is posterior.
