FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to traumatology and orthopaedics, and can be used for replacement of tissue defect of hindfoot in calcaneal bone osteomyelitis. On the posterior surface of the shin, a fasciocutaneous gastrocnemius flap is marked, the axial supply vessel of which is the artery accompanying the sural nerve, the projection of which is a line drawn along the posterior surface of the shin from the attachment point of the Achilles tendon to the middle of the popliteal fossa; the skin is incised according to the marking. Flap is separated, the size of which corresponds to the size of the formed defect of the outer surface of the calcaneal region. At 1 cm from the edge of the separated flap, a fascia is dissected thus enclosing the separated flap. Fascia is anchored to the skin part of the flap. Incision is extended proximally to the popliteal fossa. Musculocutaneous perforating vessels extending to the lateral head of the gastrocnemius muscle are identified, and the muscular portion of the tissue complex corresponding to the size of the osteomyelitic cavity of the calcaneal bone is separated. Then, from the skin part of the flap, the incision is extended distally along the posterior surface of the shin to the point around which the flap will be rotated and which is located 9 cm from the external malleolus along the fibular line. Fascial leg of the flap, which includes a sural nerve and an accompanying artery; the flap is rotated by 180 degrees into the defect area and arranged so that the muscular portion of the flap plugs the osteomyelitis cavity, and the skin portion replaces the defect of the integumentary tissues of the outer surface of the calcaneal region.
EFFECT: method provides restoration of support ability of extremity and relief of soft tissues of hindfoot due to reduction of infectious process by replacement of osteomyelitis cavity with muscular part of flap and filling of soft tissue defect.
1 cl, 3 dwg, 1 ex
