RU2311145C2 - Method for treating flat-valgus deformation of foot in children - Google Patents

Abstract

FIELD: medicine, traumatology, orthopedics.

SUBSTANCE: one should fulfill transverse osteotomy of a patient's heel bone in the front subtalar joint followed by supination of the distal fragment till coinciding its supporting facet with inferior-internal surface of talus caput; then one should fix the position of heel bone's fragments with the help of Kirschner's needles that excludes the shift of the talus, creates anatomically correct ratio in subtalar and Chopart's joints and, also, excludes the relapse of deformation.

EFFECT: higher efficiency of therapy.

4 dwg

Description

The invention relates to medicine, namely to traumatology and orthopedics.

There is a method of eliminating flat-valgus deformity of the foot in children by open reposition of the talus with osteoplastic fixation of the talacaneal joint, RF patent No. 2193365.

The disadvantages of the described method are: arthrodesis of the subtalar joint or, conversely, early resorption of the graft, which leads to a relapse of deformation due to the occurrence of hypermobility in the subtalar joint.

The objective of the proposed method is: increasing the effectiveness of treatment due to the exclusion of displacement of the talus, the creation of an anatomically correct ratio between the talus and calcaneus and in the Shopar joint, as well as the exclusion of relapse of the deformity.

The technical result of the task is achieved by performing a transverse osteotomy of the calcaneus in front of the subtalar joint, followed by supination of the distal fragment to match its supporting facet with the lower inner surface of the head of the talus, and fix the position of the calcaneal fragments with Kirschner spokes.

Figure 1 presents the talacaneal joint and the talono-navicular joint (side view) and the operation diagram:

- position 1 - calcaneus;

- position 2 - talus in pronation position with flat-valgus deformation of the foot;

- position 3 - subtalar joint;

- position 4 - scaphoid in the decentration position with flat valgus deformation of the foot;

- position 5 - place of transverse osteotomy;

- position 6 - the supporting facet of the calcaneus;

- position 7 - distal fragment of the calcaneus.

Figure 2 presents the talus and calcaneus (frontal section at the level of the heel bone facet), operation diagram, where:

- position 2 - talus in pronation position with flat-valgus deformation of the foot;

- position 6 - the supporting facet of the calcaneus;

- position 7 - distal fragment of the calcaneus;

- position 8 - level of the frontal cut.

Figure 3 presents the talacaneal joint and the ram-navicular joint (side view) after surgical treatment, where:

- position 1 - calcaneus, supination osteotomy;

- position 2 - talus;

- position 3 - subtalar joint;

- position 4 - scaphoid;

- position 5 - the place of the osteotomy after surgery;

- position 6 - the supporting facet of the calcaneus;

- position 7 - distal fragment of the calcaneus;

- position 8 - Kirchner spokes for fixing fragments of the calcaneus.

Figure 4 presents the talus and calcaneus (frontal section at the level of the heel bone facet) after surgical treatment, where:

- position 2 - talus;

- position 6 - the supporting facet of the calcaneus;

- position 7 - distal fragment of the calcaneus.

The method is as follows:

From the arcuate incision on the skin up to 4 cm, with its vertex pointing down the front-medial surface of the foot, the area of the subtalar joint and calcaneus with its supporting facet are layered in layers. In the calcaneus 1, in front of the subtalar joint 3, a transverse osteotomy 5 is made with a chisel, followed by supination of the distal fragment 7 of the calcaneus 1 until its supporting facet 6 is compared with the lower inner surface of the head of the talus 2, which helps to prevent the pronational displacement of the head of the talus 2, to create the correct the ratio between the talus and calcaneus and at the level of the Shoparov joint to form in this way the arch of the foot. Fixation of the calcaneus fragments 1 is done by Kirschner spokes 8. The wound is sutured in layers. Immobilization is carried out by a circular plaster cast.

The proposed method allows you to create an anatomically correct position of the bones of the foot, to eliminate recurrence of deformation and thus increase the effectiveness of treatment.

Claims (1)

A method of treating flat-valgus deformity of the foot, characterized in that a transverse osteotomy of the calcaneus is performed in front of the subtalar joint with subsequent supination of the distal fragment until its supporting facet is compared with the lower inner surface of the head of the talus, Kirschner spokes are fixed.

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