FIELD: medicine, traumatology, orthopedics.
SUBSTANCE: for coupling a foot's anterior department it is necessary to apply autotendon of m.plantaris which should be taken out of two incisions along posterior surface in the upper and the lower shin thirds to apply it through transosseous canal being preformed in distal metaphysis of the 1st metatarsal bones from rear part towards a sole in oblique direction. Out of additional linear skin incision at length being 2 cm, not more in area of the caput of the 5th metatarsal bone this tendon should be applied under II-III-IV metatarsal bones to withdraw it towards rear part into the space between IV and V metatarsal bones. Reverse pathway of the tendon should be fulfilled along a foot's plantar surface being above the tendons of toes' flexors to be withdrawn towards the caput of the 1st metatarsal bone. One should fulfill angular osteotomy of the 1st metatarsal bone bottom. On tightening the tendon it is important to form a flat tendinous knot at the rear part of the 1st metatarsal bone caput which should be fixed with sutures. The rest free end of autotendon should be applied through the developed transosseous canal at the bottom of the main phalanx of the 1st toe by withdrawing the 1st toe into correct position. Moreover, it is necessary to fix it at tension with sutures towards autotendon at internal surface of the 1st metatarsal bone. The innovation provides the reconstruction of correct proportions in metatarsosesamoid joint, the lift of median metatarsal bones, it prevents the misbalance in the tension of flexors' and extensors' tendons in median toes and decreases the number of postsurgical complications.
EFFECT: higher efficiency of therapy.
2 ex
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Authors
Dates
2008-01-27—Published
2006-04-25—Filed