RU2285477C2 - Method for surgical treatment of hammer deformation of great toe - Google Patents

Abstract

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should fulfill incision along posterior surface of great toe, dissect posterior capsular part of interphalangeal joint and tendon of short flexor followed by Z-shaped dissecting and lengthening of long flexor of great toe behind internal ankle. The innovation enables to remove hammer deformation of great toe at keeping its bending function.

EFFECT: higher efficiency of therapy.

2 dwg, 1 ex

Description

The invention relates to medicine and relates to methods for the surgical treatment of diseases and consequences of injuries of the musculoskeletal system, in particular hammer-shaped deformation of the first toe.

The cause of the hammer-like deformation of the first toe may be the following: cerebral palsy, trauma, myelodysplasia, distal myopathy, poliomyelitis. When the deformity is formed, the long and short finger flexors are shortened, the joint capsule is wrinkled.

A number of methods have been developed for the treatment of hammer-like deformations of the foot.

The proposed methods: a wedge-shaped resection of the first interphalangeal joint with the formation of ankylosis (Wiles method / 1 /) is impractical, since the repulsive function of the foot is disturbed when walking.

Peterson's method (2). The essence of the method is the dissection of the ligament-capsular apparatus of the interphalangeal joint. The disadvantage of this method is the inability of the flexion function of the finger due to dissection of the ligaments and tendons of the flexors of the fingers. Peterson's method is taken as a prototype.

The purpose of the invention is to correct the hammer-like deformation of the I finger while maintaining the flexion function, to reduce the number of complications.

The method is as follows: a longitudinal section along the back surface of the first finger cut through the skin and subcutaneous tissue. The edges of the wound are spread apart and held by hooks. Dissect the back of the capsule of the interphalangeal joint and two portions of the tendon of the short flexor, leaving the tendon of the long flexor intact, the wound is sutured.

A second skin incision is made behind the inner ankle in a semi-oval shape. Subcutaneous tissue and retinaculum m. flexorum A tendon of the long flexor of the first toe is isolated and taken onto the holder (Fig. 1), a 3-4 cm long tendon is dissected in a Z-shape. The finger is unbent, and the tendon is sutured in the extension position achieved by straightening the finger (Fig. 2). The wound is sutured. Impose a plaster boot from the fingertips to the middle third of the leg for 4 weeks.

On the graphic image of figure 1 shows the second stage of the operation - the allocation of the tendon at the level of the inner ankle; figure 2 - dissection of the tendon and stitching of the ends of the tendon in the elongation position.

The fundamental difference between the proposed method and the known one is to correct the hammer-like deformation by lengthening the tendon of the long flexor of the first finger at the level of the inner ankle.

The advantage of the proposed method over the known ones is as follows: when dissecting the posterior structures of the interphalangeal joint, the tendon of the long flexor is preserved, and the hammer-like deformation of the first finger is corrected by lengthening the tendon of the long flexor of the first finger while maintaining the flexion function.

The proposed method with a positive effect was performed in a patient with distal myopathy.

1. Patient Ch.I.P., 41 years old, was admitted to the clinic of traumatology and orthopedics of Samara Medical University on January 6, 2004. Since childhood, he suffers from a neurological disease. He was treated by neuropathologists with a diagnosis of distal myopathy (Fredreich's foot). Toes have a hammer-like deformation. The deformation of the first toe of the right foot is especially worrying. On the front surface of the finger there is a painful callus.

01/07/2004, the operation according to the developed method. Examined 2 months after the operation: the flexion installation of the first finger is fixed, the finger flexion function is saved.

The technical result. The lengthening of the tendon of the long flexor of the first toe of the toe behind the inner ankle makes the operation technically easier and reduces the number of complications.

Bibliography

1. Chaklin V.D. Fundamentals of operative orthopedics and traumatology. M .: Medicine, 1964, p. 720.

2. Guide to orthopedics and traumatology. The second volume. M .: Medicine, 1968, p. 7743.

Claims (1)

A method of surgical treatment of a hammer-like deformation of the first toe, including an intervention on the tendon-ligamentous apparatus, characterized in that an incision is made along the posterior surface of the first toe, the back of the capsule of the interphalangeal joint and the tendon of the short flexor are dissected, a Z-shaped dissection and extension of the long flexor of the first finger behind the inner ankle.

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