FIELD: medicine.
SUBSTANCE: invention relates to traumatology and orthopedics and can be used for surgical treatment of post-traumatic instability of ankle joint. Three accesses are made by skin punctures: access for tendon of long fibular muscle, as well as 2 arthroscopic approaches in anchor implantation zone. Longitudinal incision is made in the middle of the tendon of the long fibular muscle in the proximal direction with a splitting of the tendon and separation of its free portion. Separated free portion of the splitted tendon is dislocated from the surgical approach and used as a tendon autograft. Free end of the obtained tendon autograft and the non-split portion of the tendon are sutured with a nonadsorbable suture. Arthroscope introduced into an ankle joint is used to define a point for reaming an intraosseous canal – 0.8–1.2 cm from an apex of a lateral malleolus. Intraosseous through channel is created with diameter of 4.5 mm and length of 30–35 mm from the front back with inclination of 45°. After the tendon autograft is passed through an intraosseous through channel, it is fixed with tension to the neck of the talus by suturing the anchor screw threads. Tendon autograft is subcutaneously implanted into the fibular fibrous tubercle of the calcaneal bone, where a fixation is performed. Free end of the tendon autograft is then fixed to a residual portion of the tendon of the long fibular muscle at the point of its primary sampling.
EFFECT: method provides recovery of lateral group of ligaments, stabilization of ankle joint, restoration of dynamic support ability of the lower extremity and reduction of treatment time due to sparing sampling of the autograft and its return to the sampling zone after taking in the bone canal and paro-ostotic fixation.
1 cl, 5 dwg, 1 ex
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Authors
Dates
2019-06-25—Published
2018-04-11—Filed