METHOD FOR RECONSTRUCTION OF CALCANEAL REGION WITH COMPLETE OR PARTIAL LOSS OF CALCANEAL BONE

摘要

FIELD: medicine, traumatology and orthopedics in particular. ;SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used for the reconstruction of the calcaneus in case of its loss. The method involves replacing the defect with a musculoskeletal tissue complex from the iliac wing, which is isolated on the basis of the deep envelope of the iliac artery, and plasticizing the soft tissues of the calcaneal region with a sural skin-fascial flap. The size and shape of the bone graft is determined during preoperative planning in proportion to the height of the healthy calcaneus of the contralateral limb. In the recipient zone, a longitudinal groove in the talus bone is pre-formed, coinciding in shape and size with the bone part of the transplanted graft, into which the graft is inserted, adapting it in the defect so that the cortical layer of the bone part of the iliac wing graft faces the plantar side, and its opposite edge is wedged with a spongy substance into the pre-formed groove in the talus bone. It is fixed with Kirschner spokes, which are passed through it into the talus block from the bottom up. The size of the muscle part of the flap on the inner side of the calcaneal region, which is subsequently covered by a split skin graft, is chosen to be sufficient for suturing to the edges of the soft-tissue defect. The defect formed on the posterior surface of the calcaneal region in the area of the passage of the vascular pedicle of the graft is replaced by an insular sural skin-fascial flap. ;EFFECT: method provides the restoration of the limb's support ability due to the reconstruction of the calcaneal region by transplanting a blood-supplied musculoskeletal graft from the wing of the ilium with a fragment of the internal oblique abdominal muscle. ;1 cl, 7 dwg, 1 ex