FIELD: medicine.
SUBSTANCE: access to base of I metatarsal bone for its osteotomy is performed on medial surface at the level of plantar bone edge from 1.8 to 3.0 cm long. Osteotomy plane is placed with concave side forward. Proximal edge of osteotomy is placed not farther than 5-7 mm from joint surface of I metatarsal bone base. Osteotomy is performed with instrument with diameter, which is 2-5 mm larger than value of bone transverse section on osteotomy zone. Osteotomy axis is placed 1-4 mm more laterally than bone axis. Osteotomy is directed from distal bone end from medial-plantar surface of foot and continued proximally-dorsally-laterally: in sagittal plane, passing vertically and coinciding with axis of I metatarsal bone, osteotomy is directed at angle 45-85° from bone axis in said plane, in frontal plane, passing perpendicularly to axis of I metatarsal bone and sagittal plane, osteotomy is directed at angle 5°-45° from line of crossing of said planes. Complex varus-rotary-dorsiflection deformity of I metatarsal bone is eliminated. In case of additional correction of shortening of I metatarsal bone and foot arches distal fragment is displaced plantarly along osteotomy plane. Exostosis of I metatarsal bone head is ablated after its proximal osteotomy, correction of deformity and fixation. Reverse shevron osteotomy of main phalanx of I toe is performed with sawcuts at angle 60-130°.
EFFECT: method makes it possible to improve cosmetic look of operated foot by complete correction of deformity and elimination of its recurrences, and prevent complications.
3 cl, 1 ex
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Authors
Dates
2015-10-20—Published
2014-07-01—Filed