Tarsal V-shaped Osteotomy

Vascular osteotomy of the humerus is used for the surgical treatment of sequelae of polio - high arch. The sequelae of polio, also known as poliomyelitis sequelae, refers to a disease in which children's dyskinesia and deformity are caused by poliomyelitis caused by poliovirus. Polio is a viral infection confined to the motor cells of the anterior horn of the spinal cord and certain brainstem motor nuclei. Usually caused by one of three polioviruses. The virus initially invades the digestive tract and the respiratory tract and is subsequently disseminated to the central nervous system via a blood-borne pathway. Treatment of diseases: high arch Indication The humeral V-shaped osteotomy is suitable for moderately paralyzed high arch and foot deformities in children 6 years of age or older. The deformity of the hindfoot or middle ankle joint cannot be corrected. Preoperative preparation Regular preoperative preparation. Surgical procedure Japas method: 1. The tourniquet on the thigh root. First, a Steindler aponeurosis was performed on the inside of the heel, and then a longitudinal incision of about 6 to 8 cm was made on the back of the foot. Anatomical between the 2nd and 3rd long extensor tendons, the toe short extensor tendon is pulled to the outside, and the part of the foot between the canine and the ankle joint is exposed outside the periosteum. 2. Use a chainsaw or osteotome and bone knife to make a "V" shaped osteotomy according to the following method. The medial side of the "V" shaped osteotomy line begins at the first wedge-shaped bone, immediately adjacent to the proximal side of the first wedge-ankle joint; the lateral side is located at the tibia, slightly proximal to the fifth ankle joint. The two osteotomy lines are extended proximally to the apex of the midfoot line, the high arch foot deformity, generally on the scaphoid bone. Note that the osteotomy line does not enter the mid-tibia joint. After the osteotomy is completed, the distal end is pulled and the proximal edge is pressed against the temporal side with the periosteal stripper, and the humeral head is raised. If the first metatarsal shows a significant horseshoe deformity, the medial side of the "V" shaped osteotomy line is passed through the base of the first metatarsal to eliminate the deformity. 3. Correction of the adduction or abduction of the forefoot by hand. After a good fit, fix the osteotomy with 1 or 2 Sterling needles. Remove the tourniquet, stop bleeding, and suture the incision. If necessary, perform an Achilles tendon extension after osteotomy.

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