FIELD: medicine.
SUBSTANCE: invention relates to medicine, particularly to traumatology and orthopaedics, and can be used for treating hallux valgus. Method includes access on inner surface of foot from middle of proximal phalanx of first finger to proximal one-third of first metatarsal bone. First metatarsophalangeal articulation capsule is incised, first instep bone head is brought out into wound. Making in distal, proximal part of transverse cuts of first metatarsal bone and longitudinal osteotomy with formation of sole and back fragments of first metatarsal bone, removing plantar fragment into wound. After mobilisation of plantar fragment state cartilage covering articular part of head of first metatarsal bone is marked lateral and medial extreme points of articular cartilage and connected by a line. Then through middle of transverse distal cut on entire length of plantar fragment is carried out perpendicular to line connecting extreme points of articular cartilage of head of first metatarsal bone. At line perpendicular to distal direction from transverse distal sawing measure value required shortening of first metatarsal bone is installed on X-ray image in natural value, and a line parallel to a line drawn through extreme points of articular cartilage head of first metatarsal bone to medial edge of head of first metatarsal bone. Bone fragment produced at marking in distal part of first metatarsal bone, cut, thus forming "step". Then from end of proximal point earlier perpendicular in distal direction marked length equal to required shortening of first metatarsal bone plus 2 mm and width equal to thickness of its cortical layer. Notch is made of rectangular shape. Groove of appropriate size is formed in medullary canal in proximal fragment of back part of first metatarsal bone. After that, medially located from proximal rectangular notch ledge plantar bone fragment is immersed into medullary canal formed in recess, a distal portion of plantar fragment on “step” is brought behind distal lateral rear angle fragment of first metatarsal bone, compression along axis of first metatarsal bone there are additional cuts of plantar fragment in rear fragment of metatarsal bone to full contact and fixed screw in distal portion.
EFFECT: method prevents recurrent disease in postoperative period due to more accurate correction of inclination angle of articular surface of head of first metatarsal bone, reaching 30 degrees or more.
1 cl, 10 dwg, 1 ex
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Authors
Dates
2016-07-27—Published
2015-05-21—Filed