peroneus longus tendon transfer

The anterior tibial tendon caused by various reasons makes the diseased foot valgus and valgus, affecting the function, but the iliac crest muscle function is good. The humerus long tendon transfer can be used to weaken the muscle strength of the foot valgus, enhance the back extension force, and correct the foot. Eversion, plantar deformity. Treating diseases: valgus Indication The anterior tibial tendon caused by various reasons makes the diseased foot valgus and valgus, affecting the function, but the iliac crest muscle function is good. The humerus long tendon transfer can be used to weaken the muscle strength of the foot valgus, enhance the back extension force, and correct the foot. Eversion, plantar deformity. Preoperative preparation After a group or a muscle is paralyzed, the balance of muscle strength is imbalanced, which will inevitably cause deformity and a series of functional and structural changes after malformation. Therefore, detailed examination, careful analysis, and necessary preparations are required before surgery: 1. The number and degree of muscle spasm vary, due to the length of the date, the influence of gravity, the amount of use and the weight of the deformed foot can cause different deformities. Almost every patient's deformity has its own particularity, and even the same muscle tendon can often cause different deformities. Therefore, it is necessary to conduct a detailed examination and thorough understanding of the deformity, muscle spasm, and muscle strength of the abscess before surgery, and fully estimate whether a new imbalance will occur after the transfer, and a new malformation will occur. In this way, the surgical design can be tailored to the patient's specific situation and the expected results are achieved. Otherwise, it is very likely that the original deformity has not been corrected, but instead caused another deformity. 2. All soft tissue contracture deformities and deformities of the bone structure must be corrected before the metastasis, or corrected before surgery. It is not in principle and impossible to correct these deformities by relying on muscle strength after tendon transfer. Only after the deformity is corrected can the transferred muscle maintain the corrected condition and prevent the recurrence of the deformity. 3. After the muscle is paralyzed, the balance of muscle strength is imbalanced, and the limb function is affected to some extent, so that the muscles of the attempted atrophy will also shrink to varying degrees, the muscle strength will be correspondingly weakened, and the joint activity will be limited. Therefore, exercise should be strengthened before surgery, supplemented by physical therapy, etc., so that the function can be restored as much as possible, and the muscle strength reaches 4 to 5 to ensure the effect of surgery. 4. Prepare a sufficient range of skin as usual on the 2nd day before surgery. After the deformity of the foot, it often occurs in the weight-bearing part. Before the operation, it is necessary to soak the feet with warm water to make the skin soft and clean, in order to facilitate surgery. Surgical procedure 1. Position: supine position, slightly higher limbs. 2. Incision: There are 4 small incisions. Incision 1: a short arc-shaped incision outside the outer edge of the lateral malleolus, about 3 cm long; Incision 2: on the outside of the base of the fifth metatarsal, about 3 cm long; Incision 3: on the anterolateral side of the calf, 5-6 cm above the lateral malleolus, about 3 cm long; Incision 4: A short straight incision on the dorsal side of the first dorsal bone, 2 cm long. 3. Separation of the iliac tendon: The tibiofibular tendon and the long iliac crest were separated from the incision 1 and separately. In the incision 2, the attachment point of the tibia short muscle and the long iliac crest of the humerus were found into the iliac crest of the humerus. At these two points, the two tendons were cut with a sharp knife, and the proximal end of the short iliac crest and the distal end of the long iliac crest were placed. Do the opposite end. 4. Transfer of tendon: The proximal end of the long iliac crest is tied with a suture, and the incision 2 is withdrawn through the incision 1 to the incision 3. After the partial muscle abdomen was separated to the proximal end, a long curved hemostatic forceps was used to make a subcutaneous tunnel from the incision 4 to the incision 3, and the long iliac crest was extracted from the incision 4 through the subcutaneous tunnel. 5. Fixing the tendon: reveal the first wedge bone, cut the dorsal periosteum, and drill the first wedge bone vertically with a bone drill to make an intraosseous tunnel. Using the soft stainless steel wire to suture the end of the long iliac crest of the tibia, and then put a straight triangular needle on each end of the wire, through the intramedullary tunnel of the first cuneiform bone, penetrate the soft tissue and skin of the foot, two steel wires The skin penetration points should be 2 to 4 mm apart and pass through the two holes on the button. When the ankle joint function is set, slowly tighten the wire and pull the tendon into the tunnel until the muscle has a certain tension. The button is screwed and fixed, and the button and the skin pad are protected by several layers of gauze. In this way, the tendon is buried in the bone tunnel. The upper corner of the tendon suture wire is passed through the extracted wire for later extraction of the wire for fixing the tendon, which is taken out from the upper corner of the incision 4 and fixed outside the ankle skin. Finally, 1, 2, 3, and 4 incisions were sutured. complication After the muscles are paralyzed, the balance of muscle strength is imbalanced, and the function of the limbs is affected to some extent, so that the muscles of the untwisted muscles will also shrink to varying degrees, the muscle strength will be correspondingly weakened, and the joint activities will be limited. Therefore, exercise should be strengthened before surgery, supplemented by physical therapy, etc., so that the function can be restored as much as possible, the muscle strength reaches 4 to 5, in order to ensure the effect of surgery.

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