FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to reconstructive surgery, traumatology and orthopaedics, and is intended for treating diabetic neuroosteoarthropathy (Charcot foot), complicated by osteomyelitis. Arthrotomy and synovectomy of ankle joint are performed in stages by two arched sections with lateral and medial sides with intersection of ligamentous apparatus, but with preservation of tendon one. Deformed and affected with purulent process bones of middle foot and ankle are resected and wounds are closed. It is followed by extrafocal osteosynthesis by Ilizarov with compression-distraction apparatus, consisting of two rings, from which top one is basic, and lower ring is used for convergence of bone structures in area of resected ankle joint, as well as two semi-rings on foot: one semi-ring is installed in middle part of foot for convergence of bone structures during formation of functional arthrodesis. Installation of rings and semi-rings is performed on crosswise drawn spokes in shinbone through talus and through metatarsus bones. Semi-rings are interconnected with rods and beams. Apparatus is installed in stabilization mode to reducing edema of soft tissues in lower third of shin and foot. Then three-joint arthrodesis is made with help of compression by apparatus, wherein semi-ring in middle part of foot is in compression mode towards resected surfaces of bones. Second semi-ring is set in mode of constant stabilization. After formation of line bone beams, which is determined on radiographs, semi-ring in middle part of foot is returned at ½ of previously passed distance with subsequent stabilization. Dismantling of apparatus is performed at reliable radiographs of completed arthrodesises.
EFFECT: method enables eliminating purulent-destructive focus and deformation of foot skeleton at this background, restoring support ability of foot.
1 cl, 1 ex, 7 dwg
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