FIELD: medicine.
SUBSTANCE: conducted are clinical examination, plantography, radiography. If examining the presence of "spying fingers" symptom, the angle of rotation of the ankle and heel pronation angle. At the x-ray image is determined talonavicular I-metatarsal angle, angle of inclination of the calcaneal bone, angle talonavicular ratio. Additionally, the position of the navicular tuberosity relative to face line. Performed are the Jack test and stand-on-toes test. Based on the obtained set of data, the required volume of operations for elimination of deformation. If the plantogram reveals hyper-pronated type of the print, lowered tuberosity of navicular not more than 1/3 of the distance from Face line to the plane of support, positive tests Jack and "post on toes, moderate pronation heel bone to 10 degrees, negative indicator "spying fingers", at angle of rotation of the Shin 13-15 degrees to radiographs: talonavicular I-metatarsal in lateral projection angle of 5-8 degrees, angle of inclination of the calcaneal bone within 18-20 degrees angle talonavicular relation is less than 4 degrees is subtalar arthroereisis. If the plantogram flattened type fingerprint lowered tuberosity of navicular not more than 2/3 distance from the line of Face to the plane of support, positive test Jack, weakly positive test post on toes, negative indicator "spying fingers", at the angle pronation heel bone to 10 degrees and angle of rotation of the shin 8-13 degrees to radiographs: talonavicular I-metatarsal in lateral projection angle of 5-8 degrees, angle of inclination of the calcaneal bone 17-14 degrees angle talonavicular ratio to 4 degrees is subtalar arthroereisis with bottom relief calcaneocuboid navicular ligament and posterior tibial muscle tendon relief (SZBBM). If the plantogram flat-type valgus fingerprint tuberosity navicular lowered by more than 2/3 distance from the line of face to support plane at angle of pronation heel bone within 10-15 degrees, at positive indicator "fingers" spying weakly-positive test post on toes, negative test Jack, at angle of rotation of the shin 4-8 degrees to radiographs: talonavicular 1-metatarsal angle of lateral projection of 9-20 degrees, angle of inclination of the calcaneal bone 13-11° angle talonavicular ratio of 5-14 degrees is subtalar arthroereisis with transfer of tendon long flexor muscle of fingers on bone navicular bone and sutured together with SZBBM. If the plantogram flat-type valgus fingerprint tuberosity navicular lowered by more than 2/3 distance from the line of Face to support plane at angle of pronation heel bone within 10-15 degrees, at positive indicator "fingers" spying, negative tests "post on toes and Jack, ankle rotation angle equal to or less than 4 degrees to radiographs: talonavicular I-metatarsal angle side projection of 20-25 degrees , angle of inclination of the calcaneal bone 13-11 degrees, angle talonavicular ratio more than 15 degrees is talonavicular arthrodesis. If the plantogram reveals flat-type valgus print with the circuit and print head ankle bone, tuberosity navicular lies on the support plane at angle of pronation heel within 10-15 degrees, negative tests Jack and "post on toes" sharply positive indicator "spying fingers", at angle of rotation of the Shin 4 degrees or less, on radiographs: talonavicular I-metatarsal in lateral projection angle of more than 25 degrees, angle of inclination of the heel bone to 10 degrees angle talonavicular ratio more than 20 degrees is three-joint arthrodesis. If the plantogram flat-type valgus print with the circuit and print head ankle bone, tuberosity navicular lies on the support plane at angle of pronation heel more 15 degrees, negative tests Jack and "post on toes" sharply positive indicator "spying fingers", at angle of rotation of the Shin 4 degrees or less, on radiographs: talonavicular I-metatarsal in lateral projection angle of more than 25 degrees, angle of inclination of the calcaneal bone negative angle talonavicular ratio more than 20 degrees is three-joint fusion with osteotomy of the heel bone.
EFFECT: method makes it possible to develop optimal methods of surgical treatment of flat-valgus foot and standardising the indications for it, reducing injuries by the integrated assessment of clinical examination, plantography, x-ray imaging.
1 cl, 1 tbl, 5 ex
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Authors
Dates
2016-03-10—Published
2015-04-08—Filed