FIELD: medicine.
SUBSTANCE: invention refers to medicine, particularly to orthopaedics, and can be used for surgical treatment of non-normal hammer-like deformities of the second toe. Using a full-scale foot X-ray image, parameters are determined to eliminate foot deformation. First, a line of the longitudinal axis of the second instep bone is applied, and perpendicular to this line is drawn through the distal end point of the distal epiphysis of the second instep bone. That is followed by accessing the level of the prospective osteotomy, selecting a diaphysis of the second instep bone and performing osteotomy according to the specified parameters, deviating from the neck of the second instep bone in proximal 10 mm. Second perpendicular to the longitudinal axis of the second instep bone is drawn through the distal end of the distal epiphysis of the third instep bone. Distance between the first and second perpendiculars at extreme points is measured on the line of the longitudinal axis of the second instep bone, subtracting from obtained value 2 mm; the remaining distance is the length of the required shortening of the second instep bone. Then in the distal portion of the second instep bone, a first osteotomy line is made perpendicular to the longitudinal axis of the second instep bone, followed by a second osteotomy line parallel to the first osteotomy line, the distance from the first osteotomy line being equal to the length of the required shortening of the second instep bone. First osteotomy at angle of 80 degrees to its horizontal axis from a back to a plantar surface of a metatarsal bone in a distal direction is performed along the planned lines in a frontal plane. Osteotomized fragments of the metatarsal bone are bred, after which the second osteotomy is performed along the planned line parallel to the plane of the first osteotomy. Obtained free bone fragment is removed, the ends of the proximal and distal fragments of the second instep bone are compared. Compression along bone axis is performed until fragments fully contact and fixed.
EFFECT: method provides more accurate correction of second finger deformation, optimal distribution of load on head of metatarsal bones, restoration of motions in metatarsophalangeal joint and statodynamic function of foot, elimination of pain syndrome due to preliminary calculation of the required shortening of the second metatarsal bone on the X-ray image taking into account individual peculiarities of the foot condition of the patient, and a row of the third metatarsal bone.
1 cl, 6 dwg, 1 ex
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Authors
Dates
2021-03-18—Published
2020-03-17—Filed