Lambrinudi triarthrodesis

Lambrinudi's three-joint fusion is used for the surgical treatment of sequelae of polio. Lambrinudi's three-joint fusion is recommended for the correction of isolated fixed horseshoe malformations in children over 10 years of age. The calf triceps are still active, combined with the weakness of the dorsiflexor and the tibialis muscle, causing a foot drop deformity. The posterior part of the talus contacts the lower surface of the humerus, and the posterior capsule collapses to produce a fixed horseshoe deformity. In the Lambrinudi procedure, the wedge-shaped bone mass is removed from the distal end of the talus, so that the talus remains completely in the horseshoe position in the ankle joint, while the rest of the foot regains the desired plantar angle. If the surviving muscles still have strength. It may be necessary to perform a tendon resection or indexing to prevent the formation of a varus or valgus deformity. The Lambrinodi procedure is not suitable for use with ankle or when the hip or knee is unstable and an orthopedic brace is required. Good surgical results depend on the strength of the dorsal ligament of the ankle. If there is evidence of a detachment of the talus in the lateral position of the weight bearing, it is recommended to perform a second-stage total talar arthrodesis. Complications of Lambrinudi's three-joint fusion include residual varus or valgus deformity caused by ankle instability, muscle imbalance, and knuckle joints. Treatment of diseases: congenital clubfoot Indication Lambrinudi's three-joint fusion is suitable for: Isolated fixed horseshoe deformity over 10 years old. The calf triceps are still active, and the dorsiflexion of the dorsiflexor and the sacral muscle causes the foot drop deformity. The posterior part of the talus contacts the lower surface of the humerus, and the posterior capsule collapses to produce a fixed horseshoe deformity. Contraindications Not suitable for squatting or when the hip or knee is unstable and the orthopedic brace is required. Preoperative preparation Regular preoperative examination. Surgical procedure 1. The ankle joint and the foot are extremely flexed to take the lateral X-ray film and depict the shape of each part. Cut the map into 3 parts along the contour of the subtalar and middle ankle joints, so that the size of the talus that needs to be removed can be accurately determined before surgery. In the map, the line representing the articular surface of the pupil is to be retained, but the lines associated with the temporal and distal parts are removed so that when the scaphoid and the Achilles tendon are close together, the foot will have a slight droop. Position, the angle of inversion of 5 ° ~ 10 ° is the most appropriate, for the limb shortening can also make the angle larger. 2. The tibia is revealed by a lateral long curved surgical incision. The "Z" shape cuts off the iliac tendon, opens the scaphoid and the Achilles tendon joint, cuts the interosseous ligament and the collateral collateral ligament, so that the tibia is completely dislocated inward from the lower joint. Use a small chainsaw (more precise than an osteotome or a bone knife) to remove the wedge-shaped bone from the talar neck, the face and the distal side of the body. The cartilage and bone tissue above the calcaneus are removed to form a plane parallel to the long axis of the foot. A lateral "V" shaped groove is then made beneath the proximal side of the scaphoid and sufficient bone is removed at the ankle joint to correct any lateral deformities. The tip of the talus remains wedged tightly into the scaphoid groove and aligns with the calcaneus and talus. Be careful to place the distal end of the talus perfectly inside the groove, otherwise the position of the foot will be unsatisfactory (obviously, don't try to compensate for the tibial torsion with foot orthosis). At this time, the talus is completely locked in the horseshoe in the ankle joint, and the foot cannot be further deformed. The anastomosis of the iliac crest was performed and the incision was closed as usual.

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