METHOD OF SURGICAL TREATMENT OF THE CHRONIC LATERAL INSTABILITY OF THE ANKLE JOINT WITH THE ANTEROLATERAL ACCESS Russian patent published in 2018 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, particularly to traumatology and orthopedics. Spatial visualization of the bony structures of the ankle joint is determined by the method of multilayer helical computed tomography. Using the method of magnetic resonance imaging, evaluate the degree of damage of the anterior talon-fibular, posterior talus-fibular and heel-fibular ligaments and the character of the subluxation of the talus bone, as well as the condition of surrounding soft tissues, including the state of their vasculature, not visualized with multilayer spiral computed tomography. Perform the anterolateral arthroscopic approach 1.5 cm proximal to the apex of the external ankle and 0.5 cm lateral to the tendon of the muscle of the long flexor of the fingers. Perform the incision in the projection of the joint space. In the completed section, place the trocar and create a shaft in which the arthroscope is placed from 30° optics. Visualize the place of attachment of the talon-fibular ligament. Second port using the trocar is accessed through the joint capsule into the joint cavity. Through the second port, inject a shaver into the joint, perform the shaving of talon-fibular ligament and implant an anchor retainer with two orthocortic strands forming the four ends of the fixation yokes that are withdrawn through the second port. Perform a fan-shaped 4 incisions 1–2 mm long in the projection of the lower retainer of the extensor tendons of the foot. Each of the four ends of the anchor retainer is first percutaneously under the anterior talon-peroneal ligament to form an "arch" and then, using the Deshan needle, subcutaneously above the front talon-peroneal ligament, is withdrawn back through the second port. Then the joint is given the maximum valgus position, tighten and press the anterior talon-fibular ligament to the anatomical attachment site and tie the orthocorotal anchor retainer filaments into the knot. Check the rigidity of fixing the joint, apply seams and perform a plaster joint fixation for 3 months in the valgus position.

EFFECT: method provides frontal joint stability, prevents recurrence of instability.

1 cl, 3 ex