SU1544399A1 - Method of treating diaphysis defects of peroneal bone with foot outside subluxation - Google Patents

Abstract

The invention relates to medicine, namely to traumatology and orthopedics in the treatment of defects of the fibula of the diaphysis of the foot subluxation. In order to provide movements in the ankle joint with the restoration of the axis of the limb, a bone and subosteal flap is formed with a base in the distal part of the posterior-posterior surface of the tibial bone, it is bent and connected to the distal fragment of the fibula, covered with ribbons of demineralized bone tissue with their subsequent ejection. ankles before eliminating subluxation.

Description

(21) 4408530 / 28-14

(22) 02.22.88

(46) 02.23.90. Bul № 7

(71) Leningrad Scientific-Research Children's Orthopedic Institute

them. G. I. Turner

(72) C. L. Andrianov and A. P. Pozdeev (53) 617.089.844 (088.8)

(56) J. Bone It. Surgery, 1967, 49-A, p. 463-470.

(54) METHOD FOR TREATING A DEFECT DIA-FIZA MALOBERTSOVOP BONE WITH SUSPENDED FOOT OUTSIDE

(57) The invention relates to medicine, namely to traumatology and orthopedics in the treatment of defects of the fibula diaphysis with subluxation of the foot. In order to provide movements in the ankle joint with the restoration of the axis of the limb, a bone and subosteal flap with a base in the distal part along the posterior outer surface of the tibial bone is formed, folded and connected to the distal fragment of the fibula bone, covered with demineralized bone tissue and then retracted and external ankle to eliminate subluxation.

YU

The invention relates to medicine, namely to traumatology and orthopedics in the treatment of fibular diaphysis defects complicated by subluxation of the foot outwards.

The aim of the invention is to provide movements in the ankle joint with the restoration of the axis of the limb.

The method is carried out as follows.

A soft tissue incision is made along the posterior surface of the lower leg in its lower third to the proximal end of the external ankle. Subperiosteal for 0.5-1 cm, the proximal end of the external ankle is isolated. The posterior surface of the tibia, without separating the periosteum, exfoliates the soft tissues. A bone-periosteal graft is formed rectangular with the base in the distal part. Top edge

the bone-periosteal autograft is folded outwards, the cortical layer of the bone is cracked, and the periosteum is retained at τm. In the proximal part of the folded graft, a hole is formed into which a dedicated subperiosteal proximal end of the external ankle is inserted. The demineralized bone allotransilants cut into ribbons are placed on the posterior surface of the tibia and the proximal surface of the autograft. Retrograde, through the distal fragment of the fibula, is a Kirschner's needle. The end of it is pulled into the wound and folded into a hook. Under the base of the hook, the ends of the cut into strips of demineralized bone allotraneliplates are supplied. The wound is sewn up.

Through the proximal megaphysis, the bolus bone and the right bone are carried

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; On the bottom, the cross-knitting needles of Kirchner. Impose the device G. L. Ili-, 1 |) ova from TV rut. On the distal dial of the G.D. Ilizarov apparatus, screws are mounted), to which the end of the Kirschnier crooked needles is fixed.

In the postoperative period, subluxation moans are eliminated by asymmetric distraction 0.25mm x 4 times a day. After restoring the foot with a screw g, 0.25 mm x 4 times a day, the pro- and g (the reduction of the displaced proximal external ankle and transplants takes place. 1 2 months after the external ankle has been reduced and the foot is reduced, apparatus G. Ilizarov is removed, curved in the form The Kirschner needle is removed. During the month, the limb is fixed with a plaster cast to the upper third of the leg.

Example Patient I. Diagnosis: fibrous dysplasi, defect of the diaphysis of the left fibula, subluxation of the foot outwards. On radiographs, the defect of the fibula is determined from its middle third to the distal metaphysis, subluxation of the foot of the outside.

Operation Soft tissue incision along the posterior outer surface of the tibia, 5 cm in length to the proximal end of the external ankle. Over 1 cm, the subparticular proximal end of the external ankle is exposed. The periosteum is not divided, soft tissues are peeled off along the posterior surface of the fibular bone. The distance from the distal fragment of the fibula to the tibia is 2 cm. Perpendicular to the longitudinal axis of the external ankle, 1 cm distal from its proximal end, draws a conditional line to the nearby surface of the tibia. From the point found proximally 2 cm, a hole with a diameter of 0.7 cm is formed, which corresponds to the diameter of the external ankle with chisels on the posterior posterior surface of the tibia, which is rectangular bone-nadko- with the lateral ayi transplant, with the cortical plate and periosteum dissecting the goji bone. on the side and top above-. The width of the base of the bone-periosteal autograft is 2 cm, and the upper edge of the graft is located proximally at%, formed by an embargo of CI and BepvMtii, the edge of the costo-periosteal base is paticiu.inrai and is bent out to the outside with a chisel at the base of his periosteum.

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the bone layer of the bone. Flexible, demineralized bones, cut into strips, ie, allografts are placed on the posterior surface of the synovitis and the proximal surface of the autograft. Retrograde through the dysgal fragment of the fibula, is a Kirchner needle. The end of it is brought into the wound and folded in the form of a hook. Under the base of the hook, the ends m are cut into strips of demineralized bone allograft. The wound is sewn up.

Through the proximal metaphysis of the fibular bone and the heel bone, two mutually intersecting Kirschner spokes are drawn. The apparatus is applied by G. A. Ilizarov on two rings, a screw rod is mounted to lower the external ankle. Two weeks after the operation, unscrewing the nuts 0.25 mmX four times a day, the foot is fixed on the external surface of the tibia. The distraction of the external ankle and grafts is performed by the method of distraction osteosintech 0.25mmX4 times a day. Three months after the surgery, the device of A.A. Ilizarov was taken off. On radiographs, the formation of bone synostosis is noted, the anatomical ratio of the bones forming the ankle joint is correct.

Claims (1)

Invention Formula A method for treating diaphyseal defect fibula with subluxation of the foot outwards by forming tibiofibular syn- ocToia in the distal tibia using bone autotranspdantatov with the subsequent development of movement in the ankle joint, characterized in that in order to provide motion in the ankle joint with restoring limb axis in the posterior surface of the distal tibial bone forms a bone and periosteal flap with a base in the distal part, in the proximal part of its shape a hole is folded over, a flap is folded over, a proximal end of the distal bone fragment is inserted into the hole, a tape of demineralized bone tissue is placed on the back of the outer surface of the tibia and over the formed graft, followed by their metered and external ankle until the foot is removed.