METHOD FOR OPERATIONAL ACCESS TO MEDIAL PART OF ANKLE BONE JOINT SURFACE Russian patent published in 2017 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: after surgical medial linear access to the distal tibia, the medial ankle is isolated, leaving the attachment site of the deltoid ligament intact. Through the tip of the medial ankle, under X-ray control, two spokes are inserted at an angle of 45° to the axis of the tibia and parallel to each other, two cannulated malleolar screws are inserted along the guide spokes, forming channels therethrough for the subsequent fixation of the medial malleolus. Under X-ray control, an axial spoke is directed in the distal metaepiphysis of the tibia in the projection of the inner ankle tip, 2 centimetres above the articular cleft of the ankle joint, in the frontal plane, orienting it on the line of transition of the articular surface of the tibia to the articular surface of the medial malleolus. Further, using the axial spoke as a zero point, the medial malleolus of the ankle with an oscillatory saw is osteotomized distally in the form of a chevron with an angle between the osteotomy shoulders of 60°, as a result of which the anterior and posterior parts of the tibia remain intact, as well as the attachment site of the deltoid ligament. The osteotomized fragment of the medial malleolus is displaced medially and downward and its provisional fixation with Kirchner needles or inducing sutures is performed. After the main stage of the operation, the osteotomized fragment of the medial malleolus is laid on the mother bed and fixed with two malleolar cannulated screws, introducing them into the previously prepared channels.

EFFECT: method allows to achieve a good visualization of the articular surface of the ankle bone to perform mosaic osteochondroplasty of bone and cartilaginous defects, stability of the osteosynthesis of the osteotomized fragment of the medial malleolus is ensured, and frontal instability of the ankle joint is prevented.

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