METHOD OF SURGICAL TREATMENT OF COMPLEX STATIC DEFORMATION OF THE FOREFOOT OF PATIENTS OF OLDER AGE GROUP Russian patent published in 2021 - IPC A61B17/56 

FIELD: medicine; traumatology and orthopedics.

SUBSTANCE: arthrodesis of the first metatarsophalangeal joint is performed. Further, through the puncture access, an osteotomy of the base of the nail phalanx of the 1^st toe is performed with a variation of the nail phalanx of the 1^st toe. Then, the distal metaepiphyses of the 2^nd, 3^rd and 4^th metatarsal bones are alternately allocated. The position of the main phalanxes of the 2^nd, 3^rd, 4^th toes is corrected. Oblique osteotomy of the 2^nd, 3^rd, 4^th metatarsal bones is performed at the level of a distal metadiaphysis so that each osteotomy line is directed from the dorsum of the metatarsal bone to its plantar surface and from the distal border of the distal metaepiphysis to its proximal border. The distal metaepiphyses of the 2^nd, 3^rd, 4^th metatarsal bones are removed. The distal metaepiphyses of the proximal phalanxes of the 2^nd, 3^rd, 4^th toes are resected. Transcutaneous, transarticular fixation of the 2^nd, 3^rd, 4^th toes is performed. Through the puncture access at the border of the middle and proximal third of the diaphysis, an oblique sliding osteotomy of the 5^th metatarsal bone is performed at an angle of 45 degrees to its longitudinal axis. The distal osteotomy fragment is percutaneously shifted medially and proximally.

EFFECT: method provides the prevention of recurrence of deformation, a decrease in the number of revision interventions due to a combination of resection of the heads of the 2^nd, 3^rd, 4^th metatarsal bones and resection arthroplasty of the proximal interphalangeal joints of the 2^nd, 3^rd, 4^th toes, as well as creating a reliable arthrodesis of the first metatarsophalangeal joint.

1 cl, 2 ex, 20 dwg