FIELD: medicine; traumatology and orthopedics.
SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics and can be used for endoprosthetics of the ankle joint in posttraumatic equine-varicose deformity of the foot and ankle joint, with necrosis of the talus bone with posttraumatic osteoarthritis of the ankle joint. At the stage of preoperative planning, an MSCT study of the contralateral healthy talus bone is performed and its mirror reconstruction is performed. To do this, an individual talus implant is created taking into account such indicators as: shape, size, volume of the intact contralateral talus bone, mirrored and adapted to the side of the planned implantation. On the block of the individual implant of the talus bone, a cutout is formed according to the type of "swallow tail", suitable in shape and size to the polyethylene insert of the ankle endoprosthesis. On virtual preoperative planning, the results of measurements, relationships and spatial orientation of the talus bone in the talus, talus-navicular, ankle joints are evaluated, with an assessment of such indicators as: talo-metatarsal angle, axis of the talus bone, talus-heel angle. At the stage of surgical intervention, excision of the synovial membrane of the ankle joint is performed, the remains of the talus bone are resected and removed, and an astragalectomy of the talus bone is performed. An individual endoprosthesis of the talus bone is installed in the formed bed, adapted in shape and size to the polyethylene liner and the tibial component of the ankle endoprosthesis the joint. The tibial component of the ankle joint is installed on bone cement. An impactor is installed in the tibial component for pressing a polyethylene liner. A polyethylene liner is installed. The turnstile is removed, hemostasis is performed, the wound is sutured in layers, an aseptic bandage is applied, plaster immobilization is performed with a deep back plaster splint.
EFFECT: method provides correction of deformation, elimination of pain syndrome and preservation of movements in the ankle, rammed and talus-navicular joints through the use of an individual talus implant in combination with a tibial component and a polyethylene insert of the ankle joint endoprosthesis fixed in it.
1 cl, 20 dwg, 1 ex
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Authors
Dates
2023-07-24—Published
2022-12-11—Filed