SU1680122A1 - Method for treating talipes equinus - Google Patents

Abstract

The invention relates to medicine, namely to orthopedics, and can be used in diseases of the musculoskeletal system, in particular, equinus foot. The purpose of the invention is to prevent the recurrence of deformity by maintaining the tone of the transplanted muscles. This is accomplished by overlaying the marks on the transplanted desiccated anterior tibial muscle on the foot, the tendons are tensioned until the marks coincide, and during transplantation the tendons of the fibula are shortened to match the marks.

Description

The invention relates to medicine and relates to methods for treating diseases of the musculoskeletal system, in particular an equinus foot.

The purpose of the invention is to prevent the recurrence of deformity by maintaining the tone of the transplanted muscles.

The method is carried out as follows.

Make a skin incision on the front-foot surface. The distal tendon of the anterior tibial muscle is isolated. On the selected tendon and the skin at the same level impose seams-tags.

The second incision is made on the outer surface of the foot in a projection of the tendons of the long peroneal muscle. On the distal tendon of this muscle and the skin at the same level, stitches are put. Thereafter, a typical Z-shaped subcutaneous Achillotomy according to Beyer is made in the sagittal plane.

From the first incision, the tendon of the anterior tibial muscle is cut from the site of attachment with an awl or a drill forms a tunnel in the bones of the prefiber on the back surface. The tendon is led into the tunnel and is pulled to such a condition that the foot is held at a right angle to the longitudinal axis of the lower leg and marks skin and tendons coincided, fixed to the periosteum. Wound is sutured

Through the second incision take the taped and Z-shaped cut through the tendon of the long peroneal muscle. The tendon is tensioned until the seams-marks coincide, and the ends are stitched with shortening. The wound is sutured in layers. Impose a plaster boot from the tips of the fingers to the upper third of the thigh for 6 weeks. At the knee joint, an easy angle of cr-ibani 175 °, in the ankle 90 °

PRI me R. Sick A. 28 years old, admitted with a diagnosis of cerebral palsy, spastic lower paraparesis of the middle degree of tin,

with

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stimulating contractions of the hip joints, flexor contractions of the knee joints.

The patient moved with the help of crutches. When walking, she leaned on the distal parts of the feet.

Objectively; both feet are in an equine position. The range of motion in the ankle joints is sharply limited - flexion of 160 °, extension of 195 °. The force of the extensor muscles stop 3 points. When walking, the points of support are the front sections of the feet.

The operation was performed: subcutaneous achillotomy according to Beyer, tonic transfer of the tendons of the anterior tibial muscles to the rear of the foot, toning myoplasty of the long peroneal muscles of the feet according to the developed technique.

Operation description; skin incision on the inner surface of the right foot in the projection of the anterior tibial muscle. Selected specified tendon. On the selected tendon and the skin at the same level impose seams-tags. The second incision on the outer surface of the foot in the projection of the tendons of the long peroneal muscle. On the tendon of this muscle and the skin at the same level stitches are put.

Produced by subcutaneous Z-shaped Achillotomy by Beyer. The foot is moved to the extension position at an angle of 90.

The tendon of the anterior tibial muscle from the site of attachment is cut off from the first incision. An awl formed a tunnel in the bones of the tarsus 1.0-1.5 cm outside the site of attachment of the tendons. With the help of the guide the tendon is held in the bone tunnel. Produced tons of ha for the distal end of the tendons - the seams mark on the tendon and the skin matched. The tendon is fixed at the point of entry and exit from

tunnel catgut sutures to the periosteum. The foot is at a right angle to the lower leg. The wound is sutured.

Through the second incision, take a taped and Z-shaped incised tendon is long

fibula muscle. The tendon is tensioned until the stitches-marks coincide and stitched with shortening. The wound is sutured in layers. Alcohol dress. A circular gypsum bandage is applied from the tips of the fingers to

upper third of thigh for 6 weeks.

A similar operation was performed on the left lower limb.

From the 5th day I was engaged in static gymnastics.

After 3 days after removing the plaster cast, the patient bends and flexes the feet.

Claims (1)

The invention of the method of treatment of the equinus foot by E-shaped achillotomy, correction of the deformity with subsequent fixation, characterized in that, in order to prevent the recurrence of the deformity due to the preservation of the tone of the transplanted muscles, determine the muscle tone of the anterior tibial and long peroneal muscle, cut off the tendon of the anterior tibial muscle at the attachment point, form a channel in the tarsal bones, tendon is passed through the channel and fix it when the foot is straightened, preserving the muscle tone, the tendon of the long calf muscle is shortened with preservation her tone.