FIELD: medicine.
SUBSTANCE: external-lateral approach is made. An oblique osteotomy of a lateral malleolus is performed, its external rotation is eliminated, and the length is restored. The osteotomy is started from a distal end of the deformity upwards in the oblique direction backwards without involving a cortical layer to a proximal end of the deformity. The osteotomy is performed at the length exceeding the shortening of the lateral malleolus. That is followed by sawing outer and inner walls of the fibular bone. The cortical layer is transected on the proximal and distal fragments of the fibular bone with the saw placed in the front plane. A ring location support is applied above an ankle slot. An externally soldering pin is delivered through a heel bone which is fixed in a semi-ring support of an external fixation apparatus. Two pins or a pin and a Schanz screw is delivered through a distal fragment of the fibular bone. A length displacement is eliminated. An X-ray control is conducted. An additional apparatus correction is performed if necessary. The pin can be removed from the heel bone 3-4 weeks after the surgery taking into account the achieved reposition and stable fixation of the damage, and the apparatus can be partially demounted. If observing a rigidity of the osteotomised fragment of the lateral malleolus and evident external rotation, adhesions are dissected. The cortical layer of an upper end of the saw line and a lower end of the saw line of the fibular bone within the contact of the osteotomised fragment of the lateral malleolus. The fragment is fixed to the external fixation apparatus. The lateral malleolus deformity is eliminated by osteotomy, or a deltoid ligament is restored.
EFFECT: method provides treating lateral malleolus malunions, restoring the interactions in distal tibiofibular syndesmosis, relieving pain syndrome and support ability of the extremity, and prevents posttraumatic knee arthrosis by the oblique osteotomy of lateral malleolus, eliminating its external rotation, restoring its length and fixing in the external fixation apparatus.
2 cl, 1 ex, 5 dwg
