How to repair milusheva angle and the correction of the transverse arch of the foot and the device for its implementation

 

(57) Abstract:

Usage: in orthopedics to correct milusheva angle and the correction of the transverse arch of the foot. The method includes pulling on the back and side surfaces of the first, second and third metatarsal bones, wire, fixed in the blind channel of the metatarsal head. When this wire is made from a material with shape memory effect in the form of a bracket with three curved branches, with the direction of bending of the second and third in one direction, and the first one to meet them, and between the first and second branches bracket has an undulating curve, the plane of which is perpendicular to the plane of the hooked end of the first branches. 2 S. p. f-crystals, 2 Il.

The invention relates to medicine, namely orthopedics.

There is a method to repair milusheva angle and the correction of the transverse arch of a coupler in the form of a loop around the distal I-V metatarsal bones, made of fascial tape or canned allosauroidea method Yaremenko-Cake, which consists in holding the tie in the channel formed in the head I metatarsal bone in a horizontal direction under the distal divisions II-III-IV metatarsal bones and around the distal V PLU is the action scene in the conduct of the screed from allosphere in the channel, formed in the head of the metatarsal bone in a vertical direction, under the distal divisions II-III-IV metatarsal bones and around the distal V metatarsal bone. But these methods are complex and a large trauma (Ortop. Injuries. The prosthesis. 1972, N 4, p. 36).

Closest to the proposed method is proposed by Langenhagen, consisting in the creation of ties of steel wire, held around the distal metatarsal II and in cross-cutting, horizontal channel formed in the head of the metatarsal bone [1] the results of the operation were unsatisfactory, because due to the excessive rigidity of the material from which made the coupler (steel wire), was a fatigue fracture of the metatarsal bones in the zone of contact with the metal and loss of correction with impaired support ability of foot. The formation of the through channel in the head of the metatarsal bone contributed to its weakening. In this regard, there is a need to develop a different approach to this type of operations.

In Fig. 1-3 presents the scheme of the proposed method.

Features screed to correct milusheva angle and transverse arch of the foot in views from the second end, directed towards the second and third, staika has an undulating curve (Fig. 1 indicated by figure 4), located between the first and second branches. The choice of form ties with wavy bend due to the need to give it a spring function due to the elastic properties of the material with shape memory effect. The rigidity of the material of the coupler does not exceed the limits of the strength of the bones, hence it is not teething. The advantage of the field to another form of execution of the commit (in the form of a loop, a hook) is more uniform and a sparing effect on the metatarsal bone, i.e., not disturbed blood supply to the bones, leading to resorption, are not damaged soft tissue. The loop shape of the second branches is caused by the necessity to reduce the load at the second metatarsal bone to prevent the eruption of her designs. The coupler is from a continuous piece of wire cross-section of 1.2-1.8 mm, with shape memory effect (Fig. 1). Individuality structures is achieved by making them radiograph of the patient.

The operation is carried out on two sections, one of which is arcuate, are on the inner surface of the metatarsophalangeal joint is roughly until the middle of the head diameter. A second incision is performed on the rear surface of the foot in the projection of the second milusheva period. Allocate external surfaces II and III metatarsal bones. Then in a horizontal direction under the tendons of the extensor I, II, III fingers stupidly form a channel into which hold the plate in a pre-cooled solution of chloroethyl to a temperature of (-10)-(-20)aboutAnd a straightened condition. Enter the second and third branches on the outer surface II and III metatarsal bones, respectively, and the first field in the channel in the head of the metatarsal bone. After heating cloth moistened with hot saline solution, the coupler takes the original desired shape and size. This approach heads I, II, III, metatarsal bones and is formed by the transverse arch of the foot (Fig. 2).

Monitoring of patients within two years, confirmed by radiological control, show steady correction and no complications inherent in the prototype. The best results in operations was achieved by using titanium nickelide cross-section of 1.5 mm

P R I m m e R. Patient 38 years, operated on for left-hand transverse flatfoot. The operation carried out by the proposed method. Isplay no, the correction is saved, the support ability of foot full, there is no reaction to the metal.

1. How to repair milusheva angle and the correction of the transverse arch of the foot, including the contraction I and II of the metatarsal wire, fixed in the channel head of the first metatarsal bone, wherein the wire is fixed in the blind channel head and additionally pull together III metatarsal bone, with contractible bones cover the wire on the back and side surfaces, use a wire from a material with shape memory, which is bent in accordance with the individual characteristics of the shape and position of the bones.

2. The device for repair milusheva angle and the correction of the transverse arch of the foot, consisting of osseous wire structure, characterized in that it is made from a material with shape memory effect in the form of a bracket having three curved branches with the direction of bending of the second and third in one direction, and the first one to meet them, and the first branch has kruscovice curved end, and the bracket between the first and second branches has an undulating curve, the plane of which is perpendicular to the plane of the hooked end.

 

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