METHOD FOR THE SURGICAL TREATMENT OF ACUTE ACHILLES TENDON RUPTURE Russian patent published in 2019 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, namely to traumatology, and can be used to treat complete acute Achilles tendon rupture. Access to the site of damage to the Achilles tendon is carried out by making a Z-shaped incision along the posterior surface of the tibia in the projection of the Achilles tendon rupture. Adaptation of the ends of a torn tendon is carried out, juxtaposition of the ends with an adaptive, epitopendose, blanket stitch. Tendon is conventionally divided into 3 equal parts in the longitudinal direction. Front surface of the tendon is stitched, for which a needle is inserted at the border of 1 and 2 parts of the proximal end of the torn tendon in the direction from the tendon rupture, without seizing the entire thickness of the tendon. Then, having passed 5 mm of tendon thickness, the needle is inserted at the border of 1 and 2 parts. Further, departing from the exit of 3–4 mm, the needle is inserted at an angle of 45° relative to the parallel course of the tendon fibers in the proximal direction, the exit point of the needle is the border of 2 and 3 parts of the tendon. Then the needle is inserted into the place of exit thereof at an angle of 45° so that the needle passes under the epitenon in the proximal direction and is visible through the epitenon. Then, in the place of exit, deep, perpendicular to tendon, but not intersected the entire thickness of the tendon thread is passaged with the exit point at the border of 2 and 3 parts. Then the needle is inserted into the place of exit thereof at an angle of 45° so, that the needle passes under the epitenon in the distal direction to the border of 1 and 2 parts and is visible through the epitenon of the intersection formed with the previous stitch. Next, the needle is inserted into the place of exit thereof at an angle of 45° in the distal direction to the border of 2 and 3 parts. Then, retreating 3–4 mm, the needle is inserted parallel to the fibers and perpendicular to the tendon rupture line in the distal direction until the needle is completely out of the proximal end of the tendon, and the length of the stitched tendon should not exceed 3.0 cm. Next, give the foot equinus position. Assistant holds the tendon with clamps, without locking the ratchet. Same thread steadily continues to sew the front surface of the distal end of the tendon, using the techniques outlined above. Then the transition to the relief surface is performed, at this juncture the assistant rotates the tendon with the help of clamps. Relief surfaces of the proximal and distal ends of the tendon are stitched in the same way as the front surfaces. Ends of the threads are interconnected. Knot is arranged between the broken ends of the stitched tendon. Wound is sutured in layers. Plaster immobilization is performed on the front surface of the leg by the splint in the equinus position of the foot on the upper third of the tarsus.

EFFECT: method provides a reduction in the time of rehabilitation of the patient and a more rapid restoration of working capacity thereof due to steadily flashing of the front and relief tendon walls in four sectors.

1 cl, 11 dwg, 1 ex