METHOD FOR SURGICAL MANAGEMENT OF DEFORMATION OF SMALL TOES Russian patent published in 2022 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to orthopaedics, and can be used in treating deformities of small toes accompanied by lateral deflection of a toe in a metatarsophalangeal joint. On the full-size X-ray image of the foot, the parameters for eliminating the deformation of the small toes are determined: the length of the required shortening of the metatarsal bone and the required lateral displacement of the distal fragment of the metatarsal bone relative to its proximal fragment. For this purpose, a line of the longitudinal axis of the metatarsal bone is drawn on the X-ray image and the extreme proximal point of the epiphysis of the main phalanx of the finger, the extreme distal point of the distal epiphysis of the metatarsal bone, points of the middle of the articular surfaces of the head of the metatarsal bone and the base of the main phalanx of the finger. Calculations are made with respect to said points. Dorsal direct projection incision is then made above the distal third metatarsal bone. First point is marked on the anterior-lateral surface of the metatarsal bone on the side opposite to the lateral finger deviation at 0.5 cm from the neck of the metatarsal bone in the proximal direction. Then the second point is marked at a distance from the first point, which is equal to the length of the required shortening of the metatarsal bone. From the second point on the metatarsal bone, a line is drawn perpendicular to the long axis of the metatarsal bone; a third point is marked on this line, at a distance equal to the value of the required lateral displacement of the metatarsal bone. Thereafter, a line is drawn from the first point through the third point in the proximal direction to the opposite anterolateral surface of the metatarsal bone; along this line, an oblique diaphyseal osteotomy of the metatarsal bone is performed from the back surface to the sole of the foot perpendicularly. Distal portion of the metatarsal bone is displaced along the osteotomy plane proximally until the first and third points are aligned, and the bone fragments are fixed in the oblique proximal direction to the lateral surface of the metatarsal bone.

EFFECT: reduced traumatism of operation with elimination of deformation of small toes, optimal preservation of structures of metatarsophalangeal joint and simplifying the surgical intervention by performing the oblique diaphyseal osteotomy of the metatarsal bone and fixing the bone fragments of the metatarsal bone without damaging the articular cartilage.

1 cl, 10 dwg, 1 ex