METHOD OF TRANSFIBULAR ACCESS FOR PERFORMANCE OF OPERATIONS ON ANKLE JOINT Russian patent published in 2019 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used to perform reconstructive-plastic operations on ankle joint at terminal stage of deforming arthrosis, deformities of bones of back foot, as well as in patients with neuropathy of lower extremity to recreate its support capacity. Proposed method of transfibular access for performing operations on the ankle joint includes access, osteotomy and fixation of osteotomized fragment of lateral malleolus. Lateral surgical approach to the external ankle is carried out, leaving intact talofibular and calcaneal fibular ligaments. Oscillatory saw is used to perform a T-shaped osteotomy, in which a longitudinal osteotomy of 8 cm is made from an apex of the lateral malleolus in a frontal plane at angle of 90° in relation to the distal fragment of the fibular bone, dividing the lateral malleolus into halves. Then transverse osteotomy is performed perpendicular to lengthwise osteotomy with direction of sawing in horizontal plane at 45° in relation to anatomical axis of fibular bone with an angle open downwards. Osteotomy is performed from a front edge to a posterior edge of the fibular bone, crossing it completely. Then the apex of the lateral malleolus is completely released from the soft tissues for the subsequent mobilization of the bone fragments without touching the heel-fibular ligament. Then, anterior bone fragment is subsequently rotated, then posterior fragment is rotated. After the main stage of the operation, said distal bone fragments are laid on the maternal bed and fixed with a Lavsan thread, without fixing the distal fragments to the proximal one.

EFFECT: method provides minimizing traumatization of a lateral ligamentous complex of ankle and subtalar joints, restore an anatomical configuration of ankle joint for prevention of postoperative complications without using metal structures for fixation of lateral malleolus due to optimal access and T-shaped osteotomy.

1 cl, 14 dwg, 1 ex