FIELD: medicine; traumatology; orthopaedics.
SUBSTANCE: invention can be used for the treatment of improperly healed fractures and dislocations of the palmar edge of the base of the middle phalanx of the fingers. A solid-state STL 3D model of the phalanx of the patient’s damaged finger and the required bone autograft are formed. An incision is made in the projection of the proximal interphalangeal joint of the finger and dislocation of the middle phalanx to the rear. Resection of the damaged part of the phalanx is carried out by comparison with previously made 3D models of the phalanx of the damaged finger and bone autograft. Then the defect of the middle phalanx is measured and the parameters of the autograft from the middle phalanx of the second toe of the patient’s contralateral foot are determined, then an osteotomy of the selected area of the middle phalanx of the second toe is performed and a fragment is isolated using a chisel, cutting off the central bundle of the long extensor tendon. The autograft is fixed with two screws to the dorsal edge of the middle phalanx, the dislocation of the phalanx is reduced, and image intensifier monitoring of the position of the phalanges and screws is performed. Arthrodesis is performed with knitting needles of the proximal interphalangeal joint of the second toe, layer-by-layer suturing of the wound of the second toe and rubber drainage are performed, tendon end of the graft with the central fascicle of the common extensor finger of the hand is sutured using U-shaped sutures with adaptation sutures of the tendon edges, the skin flap is sutured with interrupted sutures, the palmar plaster splint is fixed in the position of flexion in the MCP joint at 30 degrees.
EFFECT: method allows to reduce the time of surgical intervention, ensures the most accurate reconstruction of the anatomical relationship of incorrectly fused fracture-dislocations of the palmar edge of the base of the middle phalanx of the three-phalanx fingers, ensures the implementation of rehabilitation measures in the shortest possible time, leading to the most complete restoration of the function of the damaged finger, as well as the absence of impairment vascularization and damage to the articular surfaces of the bones of the hand with a simultaneous increase in the patient’s quality of life due to the combination of techniques of the claimed invention.
2 cl, 3 ex
