AUTOPLASTY TECHNIQUE FOR PERONEAL LIGAMENTS OF ANKLE JOINT WITH TENDON OF SHORT PERONEAL MUSCLE

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to traumatology, orthopaedics and rehabilitation, to autoplasty techniques for peroneal ligaments of ankle joint. There is performed an arciform incision from the lower one-third of peroneal bone to lateral malleolus up to a middle of calcaneal bone. Skin and subcutaneous fat are dissected layer-by-layer. Fascia and muscles are separated bluntly and sharply with uncovering a distal end of a tendon of short peroneal muscle, calcaneal bone, top of peroneal bone and a neck of talus. It is followed with a longitudinal incision in the middle of the tendon of short peroneal muscle in the distal direction to divide the tendon into two equal cruses. One of them is excised at 10-12 cm from an attachment point of the tendon to a tuberosity of fifth metatarsal bone to form a constrained tendon autograft of preset length. The patient's foot is fixed in a valgus position. In the neck of talus and in a body of calcaneal bone, blind holes are formed with an anchor screw with retention sutures in its head inserted in each hole. An external part of the anchor screw with retention sutures is immersed in a bone at a depth 4-5 mm. Through lateral malleolus at 1 cm from its top, there is an intraosseous through channel formed of diametre 3.5 cm backwards with a small inclination in a sagittal plane downright. The tendon autograft is stretched intraosseously to the neck of talus with retention sutures of the anchor screw. The tendon autograft is delivered through the intraosseous through channel of the top of peroneal bone and substantially stretched in the body of calcaneal bone with retention sutures of the anchor screw with immersing of the distal end of the tendon autograft intraosseously in the blind hole of calcaneal bone. The patient's foot is positioned anatomically correctly, a wound is tightly closed.;EFFECT: technique keeps integrity of tendon of short peroneal muscles.;2 ex, 1 dwg