RU2063718C1 - Method for performing cutanoplastic operation in the cases of keller disease - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves removing transformed tissues from metatarsal bone head, placing it in its bed in reversed position, fastening with catgut or with thin rod manufactured from homobone introduced into the medullary canal. EFFECT: prevented foot deformation after resection.

Description

 The alleged invention relates to medicine, namely to orthopedics, and can be used for Keller P.'s disease.

The following methods of osteoplastic surgery are known for Keller’s disease ll:
RR Vreden’s operation, which is performed for Keller’s disease ll and consists in an osteotomy of the metathesis of the metatarsal bone in order to create the most favorable conditions for the rapid regeneration of a necrobiotic changed bone site (see, for example, Prince Vreden PP Practical Guide to Orthopedics, 1936). ;
Operation Y. S. Yusevich, which consists in removing only foreign bodies located on the back surface of the head of the metatarsal bone;
A. Denis operation, which consists in resection of the head of the metatarsal bone, and then, to align the distal foot, the heads of the IV metatarsal bones are resected (see, for example, Tateosova E.K. Surgical treatment for osteochondropathy of the metatarsal heads. Traumatology, orthopedics and prosthetics 1961 N 2, p. 22-28).

 A disadvantage of the known methods is the following. During the operation R.R. The main cause that violates the statics, foot function and causes pain is damaged, the deformed epiphysis of the metatarsal bone is not eliminated. The same drawback is in the operation of Y. S. Yusevich. Operation A. Denis crippling.

 A known method of osteoplastic surgery in Keller’s disease ll is the operation of G.V. Khondrikov, consisting in resection of the affected head of the metatarsal bone with a transplant of a piece of adipose tissue into the cavity formed after resection (see, for example, G. Khondrikov. On the question of surgical treatment marbus kohleri. Journal of Modern Surgery. 1927 at 3 (9) or G. Khondrikov. New Surgical Archive, 1929, vol. 9, No. 7 prototype).

 The disadvantage of this operation is that the transplantation of a piece of adipose tissue into the formed cavity does not prevent finger retraction and all the ensuing consequences.

 The purpose of the proposed invention is the provision of clinical recovery, restoration of foot function, prevention of foot deformation as a result of retraction of the finger into the cavity formed after resection.

 This goal is achieved by the fact that after resection of the head affected by osteochondropathy of the metatarsal bone, the resected head is freed from visible pathologically altered tissues, placed in its bed in an inverted position and strengthened with a catgut or thin “clove” from homocost introduced into the bone marrow canal, after which the antibiotic is covered with an antibiotic and sew up tightly.

The method is as follows
During the operation, a direct incision is made of the skin and fiber on the rear of the foot over the altered head of the metatarsal bone. The extensor extensor tendon is pulled to the side. The Jigley saw cuts off the distal part of the bone 2 cm long. The resected part is removed from its bed. Its proximal end is spherically processed with Luer nippers, and the head is liberated in an acute way from visible pathologically altered tissues. Then the bone is placed in its bed, but in the opposite direction and is strengthened with catgut or a thin “clove” inserted in the bone marrow canal prepared in advance from homocost. The wound is filled up with antibiotics and sutured tightly. Then a bandage. Plaster arch support for 3-4 weeks.

 The operation was performed in 8 patients with good results.

 An example of a specific implementation of the method. Patient G. 30 years. Since childhood, she suffered from pain in the right foot when walking, could not wear model shoes. Only at the age of 30 was Keller’s disease ll diagnosed. Osteoplastic surgery is a resection of the affected head of the metatarsal bone with its inversion according to our technique. Plaster arch support for 3 weeks. After 2 months, no complaints while walking. Observation with periodic x-ray control for 20 years. Walks freely in model shoes. There is no deformation of the foot. Complete morphological and functional rehabilitation.

 The proposed method of operation, unlike the known ones, eliminates the material substrate of the disease, prevents finger retraction and deformation of the foot, maintains normal statics and foot function. This is due to the fact that after such an operation, the osteoplastic process transforms the bone tissue affected by osteochondropathy into healthy tissue. And this significantly affects the structure, vascularization, rearrangement, growth and shaping of the autograft. Over time, a bone marrow canal and a semblance of a head appear. A new joint forms. Therefore, this operation gives good cosmetic, functional and anatomical results, provides for 2 years a complete restoration of the structure and bone marrow canal with the formation of a new metatarsophalangeal joint.

Claims (1)

 A method of osteoplastic surgery for Keller’s disease P, including resection of the head with osteochondropathy of the metatarsal bone, characterized in that the head after resection is freed from pathologically altered tissues, laid in its bed in an inverted position and strengthened with a catgut or thin pin made of homocosta inserted into the bone cerebral canal.