METHOD OF SURGICAL TREATMENT OF THE CHRONIC LATERAL INSTABILITY OF THE ANKLE JOINT WITH THE ANTEROMEDIAL ACCESS Russian patent published in 2019 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, namely to traumatology and orthopedics, and can be used for the surgical treatment of chronic lateral instability of the ankle with anteromedial access. Determine the degree of subluxation of the talus, the nature of damage to the ligaments and tendons. Arthroscopic access is made to the external part of the ankle joint by making a vertical incision of the skin and subcutaneous tissue 4.0–4.5 mm long along the front surface of the ankle joint 0.5 cm medial to the anterior tibialis tendon. In the incision made, an arthroscopic trocar and an arthroscopic shaft are placed, in which, after removal of the arthroscopic trocar, an arthroscope with 30° optics. Visualize the place of attachment of the anterior astragalofibular ligament, then perform an incision of the skin with a length of 4.0–4.5 mm to the subcutaneous tissue. With the use of arthroscopic trocar access through the articular capsule into the joint cavity. Form a second port. Arthroscopic shaver is inserted into the joint through the created second port, which is used to shave the anterior astragalofibular ligament attachment area and implant an anchor fixture with two orthocord strands forming the four ends of fixation threads, which are output through the second port. Fan-shaped 4 incisions with a length of 1–2 mm are made in the projection of the lower retainer of the extensor tendons of the foot, using a Deschamps needle. Each of the four ends of the anchor retainer threads is carried out first percutaneously under the anterior talus-fibular ligament to form an “arch” from the threads and then using the Deschamps needle subcutaneously over the anterior talus-fibular ligament, is brought back through the second port. Patient’s ankle joint is given a maximally valgus position, tightening and pressing the anterior talus-fibular ligament to the anatomical site of its attachment. Tie orthocord anchor retainer into knot. Arthroscopically and visually check the stiffness of the ankle joint. Stitches and perform plaster fixation of the ankle for 3 months in valgus position.

EFFECT: method provides a reduction in terms of recovery of the functions of the ankle joint, a reduction in terms of rehabilitation of the patient and improving the quality of life of the patient in the absence of a recurrence of the pathological process.

1 cl, 3 ex