Anterior tibial tendon transfer

Various causes of varus caused by the tendon tendon affect the function of the diseased foot. For patients with good tibialis anterior muscle function, anterior tibial tendon transfer can be used to reduce the muscle strength of the foot varus, thereby correcting the varus deformity. Treating diseases: knee varus Indication Various causes of varus caused by the tendon tendon affect the function of the diseased foot. For patients with good tibialis anterior muscle function, anterior tibial tendon transfer can be used to reduce the muscle strength of the foot varus, thereby correcting the varus deformity. Contraindications The patient is too old and should be filled with poor general condition. 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: A total of 3 incisions are required: Incision 1: longitudinally incision on the medial side of the first clavicle and the base of the first metatarsal, about 2 cm long; Incision 2: 4 to 5 cm on the medial malleolus, the medial edge of the tibia is longitudinally incision, about 3 cm long; Incision 3: A longitudinal incision is made on the back of the third cuneiform bone, which is about 3 cm long. 3. Isolation of the tibialis anterior tendon: The attachment of the tibialis anterior muscle to the base of the first metatarsal and the first cuneiform bone was revealed from the incision 1: it was severed with a sharp knife. 4. Transfer of tendon: The anterior tibial tendon sheath was cut at the incision 2, and the tibialis anterior tendon was isolated. For easy identification, the end can be pulled back and forth to relax verification. After separation, the crucible is withdrawn from the slit 2. 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 3 to the incision 2, and the tibialis anterior tendon was withdrawn from the incision 3. 5. Fixing the tendon: reveal the 3rd cuneiform bone, make a short intraosseous tunnel on the back of the iliac crest, make the anterior tibial tendon through the tunnel, and slowly pull it in the position of the squat and slightly outward The tight muscles are sutured until a certain tension is applied, and then the incisions are sutured. complication After muscle spasm, the balance of muscle strength is imbalanced, and limb function is affected.