Arnold surgery

Arnold surgery is used for the surgical treatment of congenital tibial defects. In addition to the ptosis of the foot and the anterior curvature of the humerus, the sacral defect has a tensioned fibrous band or fibrous cartilage band in the area of the humeral defect. This band is the main reason for continuing to increase deformity. Except for bundles with a few bones or calcified cartilage, they cannot be developed on the X-ray. Because the band starts from the lateral outer edge of the humerus and extends down to the posterior outer side of the calcaneus, it acts like a tight bowstring that causes the foot to sag and valgus, and increases the extent to which the tibia bends forward and may affect the tibia. Growth and development. Therefore, the band must be removed early and the entire tight soft tissue on the posterior side of the foot must be released. If necessary, perform Achilles tendon and humerus long and short tendon extension. If the operation is performed in infants and young children, the anterior curvature of the tibia can be gradually reduced or even completely disappeared. However, after the age of 5, although the above surgery, the possibility of natural correction of the anterior humeral deformity is rare, and finally it needs to be corrected by osteotomy. Treatment of diseases: lack of congenital tibia Indication Arnold surgery is available for: Type II congenital tibial defect with horseshoe valgus deformity, surgery should be performed after 3 months of age, the sooner the surgery is better, after 5 years of surgery, the anterior tibial deformity is difficult to correct. Contraindications 1. The general condition is poor and there are important organ diseases. 2. There are infected lesions in the skin near the surgical area. 3. The limb is shortened by more than 8cm. Surgical procedure Incision Make a wavy incision from the upper 1/3 of the lateral side of the calf to the posterior aspect of the calcaneus 12~14cm 2. Exposing and excising the fibrous cartilage band A fiber band or a band of fibrocartilage is exposed along the direction of the slit. This band is often located deep in the long and short shin of the humerus and forms the lateral muscle compartment of the lower leg. The band is attached to the upper outer side of the humerus to the outer calcaneus and has a bowstring shape. Find the distal part of the ligament at the posterior aspect of the calcaneus, and remove it as far as possible from the distal side to the proximal side. 3. Cut the switch capsule and prolong the contracture tendon In order to completely correct the foot drop and valgus deformity, the posterior lateral joint capsule of the ankle joint can be made, such as the Achilles tendon and the tibia muscle contracture, and the Z-shaped extension can be made. 4. Stitching Rinse the wound, completely stop bleeding, layer suture the skin and skin. complication The main complications of Arnold surgery are common peroneal nerve injury and recurrence of deformity. Follow the above-mentioned points of attention in the operation to avoid damage to the common peroneal nerve and achieve satisfactory correction. If the lesion is severe, the ankle joint is unstable, and sputum stabilization or fusion is needed later.

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