Patent RU-2694467-C1 (RU)
Title: Method for surgical treatment of toes deformation
Inventor: Usoltsev Ivan Vladimirovich
IPC: A61B17/56
Filed: 2018-03-12
Granted: 2019-07-15
Abstract: FIELD: medicine. 
     SUBSTANCE: invention refers to medicine, namely to orthopedics, and can be used for surgical treatment of varus-and-hammer toe deformity. X-ray image of a full-sized foot is used to define the parameters for eliminating the deformation of the toes – the length of the required shortening and the value of the required lateral displacement of the distal fragment of the metatarsal bone relative to its proximal fragment. X-ray image is drawn by a line of a longitudinal axis of a metatarsal bone; perpendiculars are drawn to this line: one – through an extreme proximal point of an epiphysis of the main phalanx of a finger and a second one – through an extreme distal point of a distal epiphysis of a metatarsal bone. Distance between first and second perpendiculars at extreme points, on line of longitudinal axis of metatarsal bone is length of required shortening of metatarsal bone. Then, two lines are parallel to the longitudinal axis of the metatarsal bone: the first line is passed through the mid point of the articular surface of the metatarsal bone head, the second line is passed through the point of the middle of the articular surface of the base of the main phalanx of the finger. Value of the required lateral displacement of the distal fragment of the metatarsal bone with respect to the proximal fragment of the metatarsal bone is established along the length of the perpendicular drawn from the point of the middle of the articular surface of the head of the metatarsal bone to the opposite parallel line. That is followed by osteotomy of metatarsal bone in distal portion of diaphysis in frontal plane at angle of 70° to its horizontal axis, deviating from the neck of metatarsal bone in proximal 10 mm, from rear to bottom surface of metatarsal bone in distal direction. Osteotomised fragments of the metatarsal bone are bred, and the proximal fragment is brought out into the wound. In the distal portion of the proximal fragment of the metatarsal bone, two intersecting lines are drawn: the first line is parallel to the osteotomy plane, the distance from the distal edge of the proximal fragment is equal to the distance equal to the length of the required shortening. Second line is perpendicular to the first line, starting from a distal edge of the proximal fragment, deviating from the lateral surface of the metatarsal bone a distance equal to the value of the required lateral displacement. Step-like recess is formed from the medial side of the metatarsal bone in the distal portion of the proximal fragment, forming a lateral projection from the lateral side. Thereafter, the proximal lateral angle of the distal fragment of the metatarsal bone is inserted behind the splay of the formed lateral protrusion, the compression is performed along the axis of the metatarsal bone until complete contact and fixed with a cannulated screw in an oblique direction from the head to the wall of the diathesis of the metatarsal bone. 
     EFFECT: method provides correcting deformity of toes, restoring statodynamic function of an anterior foot, eliminating pain syndrome by geometric constructs. 
     1 cl, 10 dwg, 1 ex