Topographic and anatomical justification use of the deep muscles of the posterior compartment of the leg for myoplasty of tibia defects

Actuality. Among the consequences of severe injuries of the lower extremities that cause permanent disability, special difficulties for surgical treatment are defects of the tibial bone, in particular after gunshot wounds. The choice of surgical treatment method for tibial bone defects must be strictly individual in each case, taking into account the nature, size, and localization of the bone defect, the condition of the surrounding tissues, and the general condition of the patient. Myoplasty of tibial defects is of great practical importance for the treatment of osteomyelitis, primarily caused by gunshot wounds. The aim of the study was to establish the expediency of using the muscles of the deep tendon of the posterior group of the leg to fill the cavities of the tibial bone by using muscle plastic, taking into account the intramuscular distribution of nerves and arteries. Methods. The macromicroscopic layer-by-layer preparation of nerves and arterial vessels of the posterior tibial area was used to prepare the right and left lower limbs of 20 fetuses of 4-10 months and 5 adult corpses of both sexes. The period of maturity for the study of the sources of innervation and blood supply of the tibialis posterior muscle, flexor digitorum longus muscle, flexor digitorum longus muscle, the number of muscle branches, the levels of their departure from nerves and arteries and the levels of entry into the abdomen of these muscles yams Particular attention is paid to the features of the intramuscular branching of the nerves and arteries of the flexor digitorum longus, flexor pollicis longus, and tibialis posterior muscle. Results. It was established that when moving the deep muscles of the posterior group of the lower leg for tamponade of the tibial cavity, the long nerve-muscular branches of the tibial nerve may remain intact. However, numerous vessels enter the length of the bellies of the posterior tibial muscle, the long muscle- flexor digitorum and flexor pollicis longus muscle. With the deep muscles of the back group of the leg, preserving the integrity of their nerves and arteries, you can fill the cavities of the back surface of the tibia within its lower half.