ANKLE JOINT DISTRACTION ARTHROPLASTY METHOD

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine and can be used for treating patients with post-traumatic changes of ankle joint. In the method, the external fixation apparatus involves a transosseous distraction osteosynthesis of the shin and foot at the first stage, creating an arthrodistasis "L" of the ankle joint with the possibility of performing motions in the joint. That is ensured by attaching the pins to the shin and fixing their ends in the proximal support of the apparatus, pins are inserted into the foot bones to fix their ends in the distal support of the apparatus. Supports of the apparatus are connected by hinged devices providing the possibility of performing foot movements relative to the shin in the joint. Foot is installed in neutral position and fixed position is fixed with hinge devices. Joint distraction is performed. Articulated devices of the apparatus are loosened to make it possible to perform foot movements relative to the shin in the joint. At the second stage, therapeutic-diagnostic joint arthroscopy is performed. For this purpose, a tourniquet is applied on the lower third of the thigh of the operated limb. Using an endoscopic post with optics and arthroscopic instruments, an anteromedial and anterolateral approaches to the ankle cavity are performed, an arthroscopic picture of joint is formed. That is ensured by examining the joint cavity, articular surfaces, wherein the foot is moved relative to the shin in the joint, the presence of adhesions, sclerosed tissues, presence of osteophytes, the state of the synovial membrane, synovial papillae, articular cartilage is determined. Performing arthroscopic therapeutic actions, including excision of adhesions and sclerosized tissues, minimally invasive debridement, resection of osteophytes, at that movement of foot relative to shin in joint is performed. Arthroscopic instrumentation is withdrawn, the foot is placed in the neutral position and the specified position is fixed with hinged devices of the apparatus, the tourniquet is removed, the postoperative physiological exercises of the foot in the apparatus are started, and the apparatus is removed after performing the therapeutic exercises.;EFFECT: method allows reducing pain syndrome and refusing or postponing arthrodesis or arthroplasty due to intraoperative elimination of existing post-traumatic changes and ankle joint unloading.;5 cl, 4 dwg, 1 ex