FIELD: medicine.
SUBSTANCE: invention relates to medicine, particularly to traumatology and orthopedics. Internal surface of the foot is provided from the base of the main phalanx of the first finger to the middle third of the first metatarsal bone. First metatarsophalangeal joint capsules are separated and dissected with excision of cicatricial portion. First metatarsal bone is exposed from the middle third to the head. Head cartilage states are evaluated. That is followed by longitudinal osteotomy of the marginal exostosis of the first metatarsal bone. Then skew-lengthwise sawing with osteotomy of first metatarsal bone from inside out from border of middle-lower one-third of inner surface of first metatarsal bone to base of head of first metatarsal bone from outer surface is performed. It is followed by sawing out the outer surface of the distal portion of the first metatarsal bone for 2 centimeters and removing cortical layer 2 mm deep, thereby forming a recess of the corresponding size in the distal portion of the first metatarsal bone. After that head of first metatarsal bone is displaced laterally by immersing in recess formed in distal part of first metatarsal bone and forming transverse arch of foot. Depth of immersion of the head is determined by the flexion of the flexor and extensors of the first toe. That is followed by fixing fragments of the first metatarsal bone with two Herbert screws in the longitudinal direction.
EFFECT: method enables using a linear type of osteotomy and bone resection, provides maximum possible head displacement and stable fixation in this position, normalization of the first intercellular angle and angle of valgus deviation of the first toe.
1 cl, 4 dwg
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Authors
Dates
2020-03-13—Published
2019-05-21—Filed