| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention relates to field of medicine, namely to traumatology and orthopedics. Triple antiseptic treatment of operation field is carried out. "Club-like" cut, curving internal ankle in projection of posterior tibial bone to the place of its attachment, is made. Skin and subcutaneous-fatty cellular tissue if dissected layer-by-layer. In blunt and sharp way fascia and muscles are separated with exposure of distal end of tendon of posterior tibial muscle, heel bone, top of internal ankle and neck of the talus. Tendons of posterior tibial muscle are mobilised from posterior edge of internal ankle to the place of attachment. It is taken on holders and top of internal ankle is exposed. Tendons of posterior tibial muscle are longitudinally dissected for the distance 7-8 cm to the place of its attachment. Dissection of tendon of posterior tibial muscle is performed on value of 1/3 of its portion in diameter with formation of non-free tendon autotransplant of specified length. Distal end of tendon of posterior tibial muscle in the point of longitudinal cut end, as well as in place of its proximal cutting off is tightly tied up with thread from non-absorbable suture material in order to eliminate its further dissociation. After that, in the body of internal ankle top and in the body of talus blind holes are made. In each hole anchor bolt with located in its head suture threads is screwed. External part of anchor bolt with suture threads is submerged into bones at the depth up to 8-10 cm. In case of varus placement of foot in form of duplication middle part of non-free tendon autotransplant is sewn and fixed with tension to anchor bolt in the body of internal ankle top, leaving distal part of tendon autotransplant free, which is sewn and fixed in transossal way with tension with suture threads of anchor bolt of talus. Patient's foot is given correct anatomical position. After-operation wound is sutured tightly. ^ EFFECT: method ensures restoration of ankle joint function, preservation of integrity of applied as autotransplant tendon of posterior tibial muscle, preservation of function of muscular "support" of injured ankle joint, elimination of possibility of development of tendon autotransplant necrosis. ^ 2 ex, 1 dwg |
