METHOD FOR SURGICAL RECONSTRUCTION OF DISTAL ONE-THIRD OF 2-4 METATARSAL BONE

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to orthopaedics. In preoperative planning determining values of proper shortening of metatarsal bone, displacement of its head in back and side directions relative to longitudinal axis of metatarsal bone, planned after reposition of angle between lengthwise segments of proximal and distal fragments. Posterior operative approach is performed in a projection of a distal epiphysial cartilage of a metatarsal bone, its dissection with formation of a distal and proximal fragments. Open ends of the fragments are processed in the instrumental way. Bone protrusion is formed from the end side of the proximal fragment, positioning it from the lateral surfaces of the metatarsal bone on a predetermined value of displacement of its head in a lateral direction relative to the longitudinal axis of the metatarsal bone. Length of projection is equal to earlier value of shortening of metatarsal bone. In the distal fragment of the metatarsal bone, on its end side, a reciprocating ledge is formed with a matching shape and size, orienting it taking into account a predetermined angle planned after repositioning between the longitudinal axes of the proximal and distal fragments, and providing position of its inlet hole with indent from rear side surface to previously determined displacement value head of metatarsal bone in rear direction relative to longitudinal axis of latter. At the same time, fragments are repositioned and fixed together by means of their connection by lock type with insertion of protrusion into mating slot.;EFFECT: method provides a single-stage multiplanar reduction with stable fixation of bone fragments without using any implanted structures, and also enables to preserve the achieved postoperative result when activating the patient by excluding the load on the artificial limb surface of the metatarsal bone.;1 cl, 1 ex, 2 dwg