Hoke surgery

Hoke surgery is used for the treatment of flexible flat feet. The deformable flat foot, or loose flat foot, is characterized by the disappearance of the medial longitudinal arch at the time of weight bearing, and the longitudinal arch can return to a normal state when the weight is not loaded. In addition, there may be a talus protruding to the medial and temporal sides of the foot, the forefoot in the plane and achilles tendon plane abduction, heel valgus and Achilles tendon shortening. Treatment should be based on non-surgical treatments, such as using an arch pad or wearing orthopedic shoes to strengthen the muscles of the foot. Surgical treatment is considered only after symptoms such as pain are severe and non-surgical treatment is ineffective. Surgical methods should be based on the patient's condition, strict surgical indications. Treatment of diseases: flat feet Indication Hoke surgery is basically the same as Miller surgery, and can be applied to the deformable flat foot of the medial longitudinal arch that collapses at the scapular joint. However, Hoke surgery only integrates the wedge joint of the boat, so it is only suitable for the medial longitudinal arch collapse only occurs at the scaphoid joint, while the first sacral wedge joint has no slack and subsidence. Contraindications Stiff flat feet or fixed foot valgus deformity, severe joint relaxation of the main joints of the feet and obvious deformity of the tibia. Preoperative preparation It includes lateral X-rays of the foot in weight-bearing and non-weight-bearing conditions, skin preparation, orthopedic instruments such as bone knives, screws and hand drills. Use epidural anesthesia or spinal anesthesia. In the supine position, the balloon tourniquet is tied in the middle of the thigh. Surgical procedure If you have a short-fitting achilles tendon, you should first extend the achilles tendon. 1. Make a longitudinal arcuate incision on the medial side to expose the wedge joint. Be careful not to damage the anterior tendon and the posterior tendon. 2. Use an osteotome to remove the articular cartilage from the scaphoid and the first and second cuneiform bones. Pull the forefoot to the sag position to restore the normal medial longitudinal arch. Maintaining this correction position, a rectangular bone block spanning the wedge joint of the scaphoid and the first cuneiform bone is formed to form a bone groove. 3. Make a small longitudinal skin incision on the inside of the upper part of the ipsilateral lower leg to expose the anterior aspect of the humerus. Use a bone knife to cut a piece of cortical bone of the same size as the bone groove at the foot of the foot, and insert the bone into the foot. Inside the bone groove at the wedge joint of the boat. 4. Suture the incision in layers.

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