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Файл:Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 345 - файл
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uses of, 35
posteromedial approach to, 27–34
dangers, 33
deep surgical dissection, 31, 31f–33f
extensile measures, 33, 34f
incision, 28, 29f
landmarks, 28
patient positioning, 28, 28f
superficial surgical dissection, 29, 30f
uses of, 27
surgical anatomy of, 61–70, 63f–68f
anterior approach to ankle, 65f, 69–70
bony structures, 66
landmarks, 66
lateral approaches to ankle, 67f, 68f, 70
medial approaches to ankle, 63f, 68–69
neurovascular bundles, 62, 64f, 65f
superficial sensory nerves, 63
tendons, 62
Ankle arthrodesis, 1, 4, 21. See also Ankle
Anterior inferior tibiofibular ligament, 10, 10f
Anterior talar sulcus, 57f, 58
Anterior talofibular ligament, 57f, 58
Anterior tibial artery, 3f, 4, 5, 53, 59, 62, 65f, 95, 149, 151f
Anterior tibiofibular ligament, 10, 10f, 57f, 58
Anterior tibiotalar joint, 57f, 58
Anteromedial navicular, 98, 98f
Arcuate artery, 274
Artery of dorsum of foot, 274, 274f
B
Base of fifth metatarsal, 50, 92, 114, 114f, 184, 185f
Bridging internal plates, 265, 269, 269f
indications for, 266
medial spanning plate, 269, 270f
Bunionectomy, 201, 205
Bunionettes
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dorsal approach to fifth metatarsal head for, 223–226
contraindication to, 223
dangers, 226
deep surgical dissection, 225, 225f
extension of, 226
internervous plane, 225
landmarks and incision, 224, 224f
patient positioning, 44f, 224
superficial surgical dissection, 225, 225f
lateral approach to fifth metatarsal head for, 227–230
dangers, 230
deep surgical dissection, 229, 229f
extension of, 230
internervous plane, 229
landmarks and incision, 224f, 228
patient positioning, 44f, 228
superficial surgical dissection, 229, 229f
use of, 227
Bunions, 201, 205, 272
Bunion surgery, dorsolateral approach for, 209–213
dangers, 213
deep surgical dissection, 211–212, 211f, 212f
extension of, 213
internervous plane, 211
landmarks and incision, 210, 210f
patient positioning, 2f, 210
preoperative assessment, 209
superficial surgical dissection, 211, 211f
use of, 209
C
Calcaneal exostosis, excision of
danger, 126
deep surgical dissection, 125
extensile measures, 126
internervous plane, 125
landmarks and incision, 124, 124f
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patient positioning, 124
posteromedial, posterolateral, and posterior midline approaches for,
123–126
superficial surgical dissection, 125, 125f, 126f
Calcaneal fractures, 113
Calcaneal osteotomies, lateral approach for, 117–121
contraindications to, 117
deep surgical dissection, 120, 121f
internervous plane, 120
landmarks and incision, 119, 119f
patient positioning, 118, 118f
skin necrosis, 121
superficial surgical dissection, 120, 120f
sural nerve, damage to, 121
use of, 117
Calcaneocuboid joint, 145, 150, 156f, 185, 185f, 186f
Calcaneofibular ligament, 115, 115f
Calcaneum, 145
lateral approach to, 113–116
contraindications to, 113
dangers, 116
deep surgical dissection, 115, 115f
incision, 114, 114f
indications for, 113
internervous planes, 115
landmarks, 114, 114f
patient positioning, 114
superficial surgical dissection, 115, 115f
Charcot-type neuropathy, midfoot collapse due to, 163
Common digital nerve, 222, 243, 243f
Compartments of foot, 278, 278f
Compartment syndrome of foot, 278
Cuboid, 153, 154, 154f
Cuboid fractures, approach to, 153–156
deep surgical dissection, 155, 156f
extension of, 156
internervous plane, 155
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landmarks and incision, 154, 154f
patient positioning, 80f, 154
superficial surgical dissection, 155, 155f
Cuneiform bone, 153
Curly toes, 245
D
Deep deltoid ligament, 57f, 58
Deep peroneal nerve, 3f, 5, 51, 53, 59, 62, 65f, 95, 149, 169f, 202, 202f,
213, 272
ischemia of, 62
Deltoid ligament, 17, 17f, 18f, 24f, 64f, 66f, 99, 99f, 100f
Distal fifth metatarsal osteotomy, 223
Dome of talus, 11f, 25f, 32f, 53f, 94f
Dorsal digital nerve, 206f, 208, 247
Dorsalis pedis artery, 151, 274, 274f
Dorsal venous arch, 272
Dupuytren’s contracture, 275
E
Extensor digitorum brevis, 51, 52f, 53, 53f, 129, 130f, 149, 150, 155,
155f, 172f, 173, 174, 176f, 272
Extensor digitorum longus, 3f, 4, 4f, 149, 226, 272
tendons, 93, 94f
Extensor hallucis longus, 3f, 4, 4f, 149, 169, 169f, 173f, 176f, 203, 204,
208
Extensor hallucis tendon, 160, 161f
Extensor muscles, ankle joint, 65f, 69
Extensor retinaculum, 3f, 4, 4f, 5f, 99, 99f, 149
ankle joint, 65f, 69–70
External fixation of ankle and foot, 265, 267–268, 267f, 268f
calcaneal pin, 268
Delta frame, 267f
half-pin placement, 268, 268f
indications for, 266
pin in fifth metatarsal, 268, 268f
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pin in first metatarsal, 268, 268f
pin placement for, 267f
skeletal pins, 265
transfixion pins or wires for, 265
F
Fascia of sole, 275
Fifth metatarsal
basal osteotomy of, 197
dorsal approach to fifth metatarsal head
for bunionettes, 223–226
dangers, 226
deep surgical dissection, 225, 225f
extension of, 226
internervous plane, 225
landmarks and incision, 224, 224f
patient positioning, 44f, 224
superficial surgical dissection, 225, 225f
lateral approach to base of, 197–200
dangers, 199
deep surgical dissection, 198
extension of, 200, 200f
landmarks and incision, 198, 198f
patient positioning, 44f, 198
superficial surgical dissection, 198, 199f
use of, 197
lateral approach to fifth metatarsal head
for bunionettes, 227–230
dangers, 230
deep surgical dissection, 229, 229f
extension of, 230
internervous plane, 229
landmarks and incision, 224f, 228
patient positioning, 44f, 228
superficial surgical dissection, 229, 229f
use of, 227
styloid process, 154, 154f, 198
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Fine-wire fixators, 266
First metatarsal, 168f, 184f
dorsomedial approach to, 187–189
dangers, 189
deep surgical dissection, 189, 189f
extension of, 189
internervous plane, 189
landmarks and incision, 188, 188f
patient positioning, 188
superficial surgical dissection, 189
use of, 187
First metatarsocuneiform joint, 185, 185f
Flexor accessorius, 139, 276
Flexor digiti minimi brevis, 276
Flexor digitorum brevis, 139, 275
Flexor digitorum longus, 139, 143, 147f, 149, 259, 276
Flexor hallucis brevis, 276
Flexor hallucis longus, 31, 31f–33f, 38, 38f–40f, 41, 111, 111f, 139, 143,
143f, 147f, 149, 203, 204, 208, 217
Flexor retinaculum, 63f, 69, 143, 143f, 149
Flexor tenotomy, 248, 248f
Flexor-to-extensor transfer, 248
Fluoroscopy, 172, 175
Foot
compartments of, 278, 278f
dorsal approaches vs. plantar approaches, 272
dorsum of foot, anatomy of, 272, 273f
artery, 274, 274f
nerve supply, 272, 273f
skin, 272
superficial veins, 272
tendons, 272, 273f, 274
sole of foot, anatomy of
deep fascia, 275
first layer of muscles, 275, 276f
fourth layer of muscles, 278
second layer of muscles, 276, 277f
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skin, 275
superficial nerves and vessels, 275
third layer of muscles, 276–278, 277f
surgical anatomy of, 272–278
Foot, hindpart
anterolateral approach to, 49–54
dangers, 53
deep surgical dissection, 51, 52f, 53f
extensile measures, 54
incision, 50, 50f
internervous plane, 51
landmarks, 50
patient positioning, 50, 50f
superficial surgical dissection, 51, 51f, 52f
lateral approach to, 71–77
dangers, 76
deep surgical dissection, 73, 75f, 76f
enlarging, 77
incision, 72, 72f
internervous plane, 73
landmarks, 72
overview, 71
patient positioning, 72
superficial surgical dissection, 73, 73f–74f
surgical anatomy of approaches to, 145–151
blood supply to talus, 151, 151f
neurovascular bundles, 149
osteology of posterolateral aspect, 148f
posterolateral aspect of foot and ankle, 146f, 147f
tarsal canal, 150, 150f
tendons, 149
Foot, middle part of, dorsal approaches to, 183–186
extension of, 186
incision, 185, 185f
internervous plane, 186
landmarks, 184, 184f
patient positioning, 44f, 184
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surgical dissection, 185f, 186, 186f
Fourth metatarsal, 92, 172, 172f
Fowler’s procedure, 275
Fractures, 272
of base of fifth metatarsal bone, 197–200
cuboid fractures, approach to, 153–156
deep surgical dissection, 155, 156f
extension of, 156
internervous plane, 155
landmarks and incision, 154, 154f
patient positioning, 80f, 154
superficial surgical dissection, 155, 155f
Lisfranc, 62
medial malleolar, 13, 15
navicular fractures, approach to, 157–162
dangers of, 157
deep surgical dissection, 160, 160f, 161f
extension of, 162
internervous plane, 160
landmarks and incision, 158, 158f, 159f
patient positioning, 2f, 158
superficial surgical dissection, 160
pilon, 1, 4, 5f
posterior colliculi, 15
sustentacular, 141
talar neck, 97, 101
G
Great toe
dorsal approach to metatarsophalangeal joint of, 201–204
dangers, 204
deep surgical dissection, 203
extension of, 204
internervous plane, 203
landmarks and incision, 202, 202f
patient positioning, 2f, 202
preoperative workup, 201
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superficial surgical dissection, 203, 203f
use of, 201
dorsomedial approach to metatarsophalangeal joint of, 205–208
dangers, 208
deep surgical dissection, 207
extension of, 208
internervous plane, 207
landmarks and incision, 206, 206f
patient positioning, 2f, 206
superficial surgical dissection, 207, 207f
use of, 205
H
Haglund’s deformity (pump bumps), removal of, 123–126. See also
Calcaneal exostosis, excision of
Half pins, 265, 267, 268
Hallux rigidus, 201, 205
Hallux valgus, 275, 276
Hammer toe, 245, 272
longitudinal approach to proximal interphalangeal joint for, 255–259
advantage/disadvantage of, 255
contraindication to, 255
dangers, 259
deep surgical dissection, 257–258, 257f–259f
enlargement of, 259
internervous plane, 257
landmarks and incision, 256, 256f
patient positioning, 2f, 256
superficial surgical dissection, 257, 257f
transverse approach for surgery to, 249–254
anesthesia for, 249
dangers, 254
deep surgical dissection, 251, 252f, 253f
enlargement of, 254
internervous plane, 251
landmarks and incision, 250, 250f
patient positioning, 2f, 250
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superficial surgical dissection, 251, 251f
use of, 249
Hindfoot, lateral approach to, 79–84
dangers, 84
deep surgical dissection, 83, 83f
enlarging, 84
internervous plane, 82
landmarks and incision, 81, 81f
patient positioning, 80, 80f
superficial surgical dissection, 82, 82f
use of, 79
Hindfoot nailing for subtalar and ankle joint fusion (plantar approach),
135–139
dangers, 139
deep surgical dissection, 138, 138f
internervous plane, 138
K-wires use, 138
landmarks and incision, 136, 137f
patient positioning, 136
second layer of muscles, 139
superficial layer of muscles, 139
superficial surgical dissection, 137f, 138
use of, 135
I
Inferior extensor retinaculum, 51, 51f, 65f, 69–70, 93, 93f
Inferior peroneal retinaculum, 67f, 70
Interosseous muscles, 278
Interphalangeal joint of hallux, 262, 262f, 264
Isolated midfoot joints, dorsal approaches for, 175–177
extension of, 177
internervous plane, 176
landmarks and incision, 176
patient positioning, 44f, 176
surgical dissection, 176, 176f
use of, 175
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