METHOD OF REVISION OSTEOSYNTHESIS WITH BONE GRAFTING OF THE INNER MALLEOLUS Russian patent published in 2023 - IPC A61B17/58 

FIELD: medicine, traumatology and orthopedics.

SUBSTANCE: proposed method can be used for reosteosynthesis of ununited fractures and false joints of the inner ankle. After osteosynthesis of a fracture of the medial malleolus, there remains a high risk of metal structure migration, secondary displacement of fragments, the formation of a false joint and contracture, and the development of deforming osteoarthrosis. These complications require a second operation, which eliminates the consequences of ineffective consolidation. For the first time, a method of revision osteosynthesis of ununited fractures was proposed, the said method is repeated open reposition of fragments with the extraction of the screw holding them together, sawing out the autograft from the tuberosity of the tibia, grinding it along the diameter and length of the extracted screw, and its further immersion in the maternal bed being a channel left after screw, fixing the ankle along the edges of the graft with two Kirschner wires with their ends being bent in the form of loops and bitten at the end of the loop, the screw for osteosynthesis is installed in the tibia above the fracture site and is passed around the screw head and through the loops of the ends of the wires eight-shaped tightening wire loop, fixing the spokes and the screw between each other, creating compression in the fracture zone.

EFFECT: when using the proposed method, favorable conditions are created for consolidation due to the high osteogenic potential of the autograft from the tibial tuberosity and additional fixation of the ankle to the tibia with Kirschner wires, the formation of loops at their ends and tightening with a cerclage-wire loop, which helps to reduce the risk of metal structure migration.

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