METHOD OF TREATING SEVERE FOOT DEFORMATION IN PATIENTS OVER 12 YEARS OF AGE WITH CHARCOT-MARIE-TOOTH DISEASE Russian patent published in 2019 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention refers to clinical medicine, namely to traumatology and orthopedics, and can be used for treating severe foot deformities in patients older than 12 years with Charcot-Marie-Tooth (CMT) disease. Percutaneously performing Z-shaped achillotomy, planotomy is performed, external fixation apparatus (EFA) supports mounting on foot and shin. That is ensured by conducting the pins through the shin and foot bones, the pins in tensioned condition being attached to the corresponding supports EFA, supports EFA, fixed on foot and shin, are connected to each other with possibility of mutual movement. EFA performing gradual dosage correction of foot deformation. After the deformation is eliminated, a stabilizing operation is performed. That is ensured by arched incision along the external foot surface under an external malleolus; three-articular fusion is performed; the articular cartilage is economically removed from the talonavicular, talocalculus, calcaneocuboid joints. Footstep is set in hypercorrection position on all available components of foot deformation. Ankle, calcaneal bone and anterior foot are fixed in a predetermined position EFA, by attaching the pins to the supports EFA, EFA compression is performed in the area of arthrodesis, then a tendon of posterior tibial muscle is transplanted into cuboid bone. That is ensured by four incisions, a first incision being made in the projection of the navicular and medial wedge-like bones, the second incision being made at 2 cm posterior and 3–4 cm above the inner ankle, the third incision along the anterior-external surface of the lower one-third of the shin, and the fourth one in the projection of the cuboid bone. From the first incision, the tendon is sutured and cut off from the attachment point, the tendon is drawn proximally from the second incision, a canalis is made between the shin bones and a tendon is drawn from the second incision into the third incision. Then, the tendon is pulled distally to the foot from the third incision into the fourth incision; the tendon is anchored to the bone with an anchor fixator with sutures. Tendon is fixed in the reached position of the foot due to screwing the anchor retainer into the bone and binding the anchor threads to the threads drawn through the tendon. Wounds are treated, the position of the foot is fixed in the achieved position by the external fixation apparatus. After the fixation period, the external fixation apparatus is dismantled.

EFFECT: method provides eliminating severe multicomponent foot deformation, achieving active rear flexion, restoring muscular balance in shin-foot segments, reduced risk of complications, recurrence of deformation, reduced traumaticity of operation due to performing three-articular arthrodesis and fixation in EFA.

1 cl, 10 dwg, 1 ex