METHOD FOR SURGICAL CORRECTION OF EQUINO-FLAT-VALGUS FOOT DEFORMATION IN CHILDREN WITH SPASTIC ICP FORMS Russian patent published in 2020 - IPC A61B17/00 A61B17/56 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology, orthopaedics and paediatric surgery, and can be used for surgical treatment of equino-flat-valgus deformation of feet in children with spastic forms of infantile cerebral paralysis. Subtalar sinus is accessed, the tendons of the long and short fibular muscles are separated, and the equinus strain component is eliminated depending on the result of the Silfverskiold test either by Strayer or z-shaped achilloplasty. That is followed by a z-shaped dissection of the tendon of the long fibular muscle with short fibular muscle plasty. That is followed by accessing the medial part of the foot to isolate the anterior portion of the tendon holder and the talonous ligament of the deltoid ligament and subsequent arthrolysis of the talocalculus, talonavicular and addition navicular-wedge-like joints. Tendon of the posterior tibial muscle is separated and mobilized to the point of attachment to the navicular bone; the foot is brought into the correction position by correcting an ossus and fixed through the first metatarsal, wedge-shaped, navicular and ankle bones to create a single longitudinal axis. Then, from the portion of the deltoid ligament and the tendon holder, a neovaginalis is formed for a tendon of the posterior tibial muscle, having previously displaced it upward and forward. These ligaments are fixed with transosseous sutures to navicular bone, forming a canal fixing tendons of posterior tibial muscle along back surface of navicular bone. That is followed by arthrodesis of a fibular autotransplant pre-modeled by the shape of a subtalar sinus with a chamfer on the top of the graft at angle of 30°, by means of spokes. For final immobilisation, a deep gypsum splint is applied from the finger tips to the upper one-third of the thigh with maximum knee joint extension, with angle of 90° in ankle joint, when performing operation by Strayer, or 100° in case of z-shaped achilloplasty for 8 weeks.

EFFECT: method enables complete, minimally traumatic correction of all components of equino-flat-valgus deformation, active-dynamic foot balance redistribution and creating a stable extra-articular subtalar arthrodesis in ICP children by forming a stable arthrodesis of a subtalar joint, which is supplemented by tendon plasty, which enables effective correction of muscle imbalance caused by spastic disorders.

1 cl, 8 dwg, 2 ex