METHOD FOR SURGICAL CORRECTION OF DIVERGENT HAMMER-LIKE DEFORMITY OF TOES

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to orthopedics and traumatology, and can be used for correction of divergent hammer-like deformation of toes. Through skin incisions on a dorsum foot surface in a projection of proximal interphalangeal joints 2 and 3 fingers and gap between 2 and 3 metatarsophalangeal joints, capsulotomy and arthrodesis of the proximal interphalangeal joint of 2 and 3 toes is performed. That is followed by distal transverse osteotomy 2 and 3 metatarsal bones with subsequent fixation of the osteotomy zone with bicortical screws after correction of the head position in the back and side directions until rotation centers 2 and 3 of the metatarsophalangeal joints and the bones forming them in the horizontal plane are normalized in mutually opposite directions with movement of heads dorsal in sagittal plane. That is followed by tenotomy of short and prolonging tenoplasty of long extensors 2 and 3 of fingers. Through skin incisions on plantar surface of foot in projections 2 and 3 of metatarsophalangeal joints excising fragments of plantar plates, adaptation of the latter and suturing, tenotomy flexor 2-3 fingers. Excised fragments have a trapezoidal shape, wide base of which is directed towards the second intermetatarsal space, and their dimensions are determined so that after matching and stitching of their edges, providing recovery of passive stabilizing forces in the direction of plantoflexion and opposite deviation / divergence. A tenotomy of short finger flexors is performed at the level of head of metatarsal bones with their subsequent fitting of distal fragments to tendons of long flexors of adjacent divergent fingers, ensuring elimination of their lateral deviation.;EFFECT: method provides effective elimination of divergent hammer-shaped deformation of toes and recovery of balance of passive and active stabilizers of metatarsophalangeal joints due to normalization of rotation centers of metatarsophalangeal joints, restoration of their plantar plates with creation of correcting and stabilizing efforts in them and correction of vectors of active stabilization of metatarsophalangeal joints in sagittal and horizontal planes.;1 cl, 2 ex, 12 dwg