METHOD FOR REPLACING COMBINED POSTTRAUMATIC EXTENSIVE SHIN TISSUE DEFECT Russian patent published in 2023 - IPC A61B17/00 A61B17/56 

FIELD: medicine; traumatology; orthopaedics; plastic surgery.

SUBSTANCE: invention relates to treatment of congenital hip dislocation. The incision line is marked to isolate the flap along the outer surface of the intact leg. A wavy incision is made above the pedicle of the flap, an arcuate incision is made along the anterior edge of the fibular flap to the muscle tissue, the fascia covering the muscles is sutured to the flap. Feeding perforating arteries passing in the intermuscular septum are found. The peroneal muscle is separated from the fibula. The peroneal vascular bundle is isolated, the incision is continued to a circular one, an osteotomy of the fibula is performed with the release of a bone fragment, and the pedicle of the fibular flap is isolated. A full-thickness skin graft is taken from the iliac region to cover the flap stem, and the flap stem is wrapped. Re-osteosynthesis is performed with an apparatus for external fixation of the damaged lower leg and foot, and of the intact lower leg and foot. Devices are installed on both legs. In the wound of the injured leg, hypergranulations are removed, the ends of the tibia are isolated, and the bone endplates are removed from the ends of the fragments of the tibia. Osteotomy is performed through the area of the false joint of the fibula. A bed is formed for a fragment of a complex non-free vascularized flap with a fragment of the fibula, external fixation devices are interconnected using hinged nodes. A non-free vascularized flap with a fragment of the fibula taken from the intact leg is placed in the defect of the tibia, the fragment of the fibula is fixed with an intramedullary pin. Stitches, bandages are applied and drainage is established.

EFFECT: possibility of simultaneous replacement of a complex defect in the tissues of the lower extremities, including bone tissue, integumentary tissues, muscles through the use of a complex non-free flap based on peroneal vessels from the opposite leg.

1 cl, 10 dwg, 1 ex