Fig. 2

A posteromedial approach to the ankle was used. The skin incision started approximately 8 cm proximal to the medial malleolus (MM) and extended nearly to the level of the talocalcaneonavicular joint (a). Small incisions approximately perpendicular to it were done to facilitate the retraction of the skin. The skin was carefully retracted leaving the superficial fascia, intact. Then, the superficial fascia was carefully removed to preserve the vascular and nervous structures lying in it (b). The deep fascia, and a band-shaped thickening of it, the flexor retinaculum (FR), were identified. The deep fascia was removed leaving the FR intact and the proximal part of the abdutor hallucis (AH) was identified and dissected (c)