METHOD OF ANKLE REPLACEMENT Russian patent published in 2024 - IPC A61B17/56 A61F2/42 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology, orthopaedics and oncology, and can be used for ankle replacement. Prior to the operation, an individual stereolithographic replaceable element of a resection module of a guide support for extremity is 3D printed on the basis of the CT images of the talus so that the relief of the surface of the replaceable element when matched corresponds to the relief of the resected talus. Guide support for the extremity is placed on the operating table, the patient’s hip, shin and foot are fixed to its support module. Bearing bar scale is used to measure the distance between the guide bushing and the proximal bushing of the support platform of the support module. Foot support plate is removed. Skin and subcutaneous fat, proper fascia are dissected along anteromedial surface of shin. Upper and lower extensor tendon retainers, an anterior tibial muscle, an extensor digitorum longus are transected, an extensor hallucis longus muscle is separated and retracted medially. Lower tibia is skeletonised by cutting off a deltoid ligament, an anterior tibiofibular ligament and a joint capsule. Tibia osteotomy is performed to separate a posterior group of shin muscles; a lower segment of the tibia is dislocated and removed while preserving the fibular bone with its ligaments. Bone marrow canal of the tibia is drilled out; plate for foot stop is installed again to support module of support and it is fixed. Talus surface is skeletonised. Resection module with an individual stereolithographic replaceable element is fixed to the support module until it is aligned with the surface of the resected talus. Guide canal is drilled in the talus through the opening of the resection groove of the resection plate. With the help of an oscillatory saw, an ankle bone is resected through the slot. Resection module is removed. Talar component of the endoprosthesis is placed with its lower surface on the talus bonesaw-line and fixed with screws. Body of the tibial component together with the insert is matched with the articular surface of the talar component by passing them through the through slots of the limiting rod. Intramedullary pedicle connected to an extension module, which is also connected to the upper part of the tibial component, is implanted into the bone marrow canal of the tibia. Module for stretching the foot is fixed to the support module of the platform. Due to the movement of the traction screw of the module, the foot is displaced distally, comparing the upper part of the tibial component of the endoprosthesis and its body. Reverse movement of the screw enables to achieve congruence of the endoprosthesis components. Distance between the guide bushing and the proximal bushing of the support platform is measured. Module for stretching the foot and the plate for the foot support are removed. Cut ends of the anterior and posterior tibiofibular ligaments are fixed to the holes in the endoprosthesis body. Passive movements are performed in the joint. Wound is closed.

EFFECT: method provides reduction of postoperative complications due to accuracy of measurements performed during operation.

1 cl, 2 ex