METHOD FOR THREE-JOINT ARTHRODESIS OF THE FOOT IN PATIENTS WITH SPASTIC CEREBRAL PALSY Russian patent published in 2022 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery and orthopedics, and can be used when performing three-articular arthrodesis of the foot in patients with spastic cerebral palsy. The equinus component of the deformity is eliminated by performing an aponeurotomy of the gastrocnemius muscle. A longitudinal incision is made along the posterior-medial surface, on the border of the middle and upper thirds of the leg. Produce layer-by-layer dissection of soft tissues. The aponeurotic part of the gastrocnemius muscle is isolated, and its dissection is performed. Then a medial incision is made on the foot. Layer-by-layer dissection of soft tissues is performed. The tibialis posterior muscle is isolated. Capsulotomy of the talonavicular joint is performed. Corrective resection of the articular surfaces is performed, arthrodesis is performed from two surgical accesses located along the medial and lateral surfaces of the foot. Osteosynthesis is performed ante- and retrograde from two surgical approaches. To do this, an arcuate lateral incision is made on the foot, a short extensor of the fingers is isolated with a U-shaped flap, the base facing anteriorly, the tendons of the short and long peroneal muscles are isolated, the calcaneocuboid joint is exposed, and a corrective resection of the articular surfaces is performed. From the lateral incision, resection of the articular surfaces of the subtalar joint is performed, osteosynthesis of the talus, scaphoid, cuboid and calcaneal bones is performed, in accordance with figure 3 presented in the application materials. From the medial incision, osteosynthesis of the subtalar joint is performed. The screw is inserted in the oblique-sagittal plane. Arthrodesis of the subtalar joint is carried out from the medial approach in the oblique-sagittal plane, talonavicular - from the medial approach in the horizontal plane, calcaneocuboid joint - from the lateral approach in the horizontal plane. Produce layer-by-layer suturing of the wound with the restoration of the attachment site of the short extensor of the fingers.

EFFECT: method provides connection of the talus, scaphoid, cuboid and calcaneal bones, stabilization of the subtalar and Choparov joints of the foot, without arthrodesis of the Lisfranc joint, and restoration of the support ability of the lower limb due to the use of submersible metal osteosynthesis.

1 cl, 5 dwg