METHOD FOR LENGTHENING TOE PHALANX IN CASE OF BRACHIPHALANGIA USING AN AUTOGRAFT Russian patent published in 2023 - IPC A61B17/58 

FIELD: medicine, surgery and orthopaedics.

SUBSTANCE: invention can be used to lengthen the toe phalanx in brachiphalangia using an autograft. A lateral exposure is performed longitudinally in the proximal direction parallel to the phalanx of the finger to the level of the proposed osteotomy. The site of osteotomy is exposed in layers, the proximal metaepiphysis and the middle third of the diaphysis of the phalanx are isolated at the site of osteotomy. A transverse osteotomy is performed: the saw blade is set parallel to the frontal plane of the phalanx at a distance of 0.5 cm from the articular cartilage line of the metatarsophalangeal joint from the rear to the sole of the foot, the saw blade is placed at an angle of 90° to the horizontal axis of the metatarsal. Graft is sampled from the diaphysis of the proximal phalanx of the 5th toe. Lateral exposure is performed parallel to the proximal phalanx of the finger in the projection of the proposed osteotomy, the diaphysis of the proximal phalanx is isolated, the first osteotomy is performed proximally 0.5 cm from the border of the articular cartilage, the saw blade is oriented perpendicular to the proximal phalanx from the outside inwards. The distance required for the graft is receded distally, the second osteotomy is performed parallel to the first, so that a cylindrical graft is obtained. The graft is placed in saline, NaCl 0.9%. Two segments of the diaphysis are installed parallel to each other. The pin is passed through the base of the proximal phalanx, the entry point of the pin is located on the outside of the phalanx. The pin is oriented into the medullary canal to the distal edge of the phalanx. The cortical layer is reamed to the chondral layer of the distal segment of the phalanx. The fragments are fixed by passing a cannulated, self-reaming, compressing screw, which is inserted along a previously installed pin. The graft is placed in the area of the previously performed osteotomy of the proximal phalanx of the shortened finger, restoring the alignment of the proximal, distal fragments and the graft. Transarticular fixation of the osteotomy is performed using a 1 mm Kirschner wire, passing it percutaneously through the distal phalanx in the direction of the metatarsal head. Reaming with a cannulated drill along the wire through the distal phalanx up to 6-7 cm in the medullary canal of the metatarsal bone is performed, fixing the fragment in the area of the proposed fusion.

EFFECT: method provides reduction of period of treatment and rehabilitation due to one-stage elimination of defect of bone shortening of finger phalanx.

1 cl, 4 dwg, 2 ex