MD976Z - Method for angioplasty of patellar tendon septic defects - Google Patents
Method for angioplasty of patellar tendon septic defects Download PDFInfo
- Publication number
- MD976Z MD976Z MDS20150019A MDS20150019A MD976Z MD 976 Z MD976 Z MD 976Z MD S20150019 A MDS20150019 A MD S20150019A MD S20150019 A MDS20150019 A MD S20150019A MD 976 Z MD976 Z MD 976Z
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- Moldova
- Prior art keywords
- tendon
- flap
- vascular pedicle
- sutured
- concavity
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- 210000000426 patellar ligament Anatomy 0.000 title claims abstract description 17
- 230000007547 defect Effects 0.000 title claims abstract description 9
- 238000000034 method Methods 0.000 title claims abstract description 9
- 238000002399 angioplasty Methods 0.000 title 1
- 230000002792 vascular Effects 0.000 claims abstract description 12
- 210000001361 achilles tendon Anatomy 0.000 claims abstract description 11
- 210000002435 tendon Anatomy 0.000 claims abstract description 10
- 210000003195 fascia Anatomy 0.000 claims abstract description 7
- 239000012634 fragment Substances 0.000 claims abstract description 4
- 210000002303 tibia Anatomy 0.000 claims abstract description 4
- 239000003814 drug Substances 0.000 abstract description 3
- 238000002316 cosmetic surgery Methods 0.000 abstract description 2
- 210000003423 ankle Anatomy 0.000 abstract 1
- 206010052428 Wound Diseases 0.000 description 3
- 208000027418 Wounds and injury Diseases 0.000 description 3
- 210000001519 tissue Anatomy 0.000 description 3
- 208000021945 Tendon injury Diseases 0.000 description 2
- 229940124645 emergency medicine Drugs 0.000 description 2
- 230000003137 locomotive effect Effects 0.000 description 2
- 230000000399 orthopedic effect Effects 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 206010061218 Inflammation Diseases 0.000 description 1
- 206010065433 Ligament rupture Diseases 0.000 description 1
- 210000000988 bone and bone Anatomy 0.000 description 1
- 230000015556 catabolic process Effects 0.000 description 1
- 230000006378 damage Effects 0.000 description 1
- 230000007812 deficiency Effects 0.000 description 1
- 238000006731 degradation reaction Methods 0.000 description 1
- 238000003745 diagnosis Methods 0.000 description 1
- 238000005553 drilling Methods 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 210000003414 extremity Anatomy 0.000 description 1
- 208000015181 infectious disease Diseases 0.000 description 1
- 230000004054 inflammatory process Effects 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 230000003902 lesion Effects 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 238000002406 microsurgery Methods 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- 230000017074 necrotic cell death Effects 0.000 description 1
- 210000004417 patella Anatomy 0.000 description 1
- 230000002980 postoperative effect Effects 0.000 description 1
- 238000002278 reconstructive surgery Methods 0.000 description 1
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- Prostheses (AREA)
Abstract
Invenţia se referă la medicină, în special la traumatologie şi chirurgia plastică şi poate fi utilizată pentru plastia vascularizată a defectelor septice de tendon patelar.Conform invenţiei, metoda constă în aceea că se efectuează examenul doplerografic cu stabilirea proiecţiei vaselor, apoi se efectuează două incizii curbate de-a lungul marginii interne a tibiei în direcţie proximală, care încep la 6 cm deasupra vârfului maleolei mediale, formând un lambou elipsoidal, prima incizie fiind îndreptată cu concavitatea în partea medială de-a lungul marginii laterale a tendonului achilian, iar a doua îndreptată cu concavitatea în partea laterală, se evidenţiază fascia de inveliş, tendonul achilian şi pediculul vascular safen, lamboul, având lăţimea de 2 cm, lungimea de 12 cm şi grosimea de 3 mm, este compus din cutaneu, fascia de înveliş cu pedicul vascular şi lamboul tendinos alcătuit din porţiunea patrulateră a părţii mediale a tendonului achilian, apoi se efectuează incizia regiunii inferioare a lamboului, care este ridicat, rotit în direcţia proximală a pediculului vascular integru şi plasat în defectul menţionat al regiunii infrapatelare, după care capetele lamboului tendinos sunt introduse în breşele sagitale ale fragmentelor tendonului patelar şi suturate, iar plaga este suturată pe straturi.The invention relates to medicine, in particular to traumatology and plastic surgery and can be used for the vascularized plasticity of septic patellar tendon defects. According to the invention, the method consists in performing the doplerographic examination with establishing the projection of the vessels, then making two curved incisions. along the inner edge of the tibia in the proximal direction, beginning 6 cm above the tip of the medial ankle, forming an ellipsoidal flap, the first incision being directed with the concavity in the medial part along the lateral edge of the achilles tendon, and the second straight with the concavity on the lateral side, the sheath fascia, achilles tendon and saphenous vascular pedicle are highlighted, the flap, having a width of 2 cm, a length of 12 cm and a thickness of 3 mm, is composed of the skin, the sheath band with the vascular pedicle and the flap tendon made up of the quadrilateral portion of the medial part of the ach tendon ilian, then the incision of the inferior region of the flap is made, which is raised, rotated in the proximal direction of the whole vascular pedicle and placed in the aforementioned defect of the infrapatellar region, after which the ends of the tendon flap are inserted into the sagittal breaches of the patellar tendon fragments and sutured, and the wound is sutured in layers.
Description
Invenţia se referă la medicină, în special la traumatologie şi chirurgia plastică şi poate fi utilizată pentru plastia vascularizată a defectelor septice de tendon patelar. The invention relates to medicine, in particular to traumatology and plastic surgery and can be used for vascularized plasty of septic patellar tendon defects.
Este cunoscută metoda de tratament chirurgical al leziunilor tendonului patelar, şi anume tehnica de plastie a ligamentului patelar în rupturile vechi ale ligamentului patelar prin plastie cu lambou cutaneo-aponeurotic medial din inserţiile tendoanelor muşchilor semitendenos şi gracilis trecute prin canale osoase [1]. The surgical treatment method for patellar tendon injuries is known, namely the patellar ligament repair technique in old patellar ligament tears by using a medial cutaneous-aponeurotic flap from the tendon insertions of the semitendinosus and gracilis muscles passed through bone canals [1].
Dezavantajele acestei metode sunt deteriorarea mecanică a rotulei prin aplicare de cui metalic şi forare de canale, riscul mare de infectare a lamboului tendinos, ce poate duce la degradarea lamboului cu apariţia leziunii inveterate de tendon patelar. The disadvantages of this method are the mechanical damage to the patella by applying a metal nail and drilling channels, the high risk of infection of the tendon flap, which can lead to degradation of the flap with the appearance of an inveterate patellar tendon lesion.
Problema pe care o rezolvă invenţia este extinderea arsenalului de metode utilizate pentru tratamentul leziunii tendonului patelar şi a ţesuturilor supraiacente. The problem that the invention solves is the expansion of the arsenal of methods used for the treatment of patellar tendon injury and overlying tissues.
Esenţa invenţiei consta în aceea că se efectuează examenul doplerografic cu stabilirea proiecţiei vaselor, apoi se efectuează două incizii curbate de-a lungul marginii interne a tibiei în direcţie proximală, care încep la 6 cm deasupra vârfului maleolei mediale, formând un lambou elipsoidal, prima incizie fiind îndreptată cu concavitatea în partea medială de-a lungul marginii laterale a tendonului achilian, iar a doua îndreptată cu concavitatea în partea laterală, se evidenţiază fascia de înveliş, tendonul achilian şi pediculul vascular safen, lamboul, având lăţimea de 2 cm, lungimea de 12 cm şi grosimea de 3 mm, este compus din cutaneu, fascia de înveliş cu pedicul vascular şi lamboul tendinos alcătuit din porţiunea patrulateră a părţii mediale a tendonului achilian, apoi se efectuează incizia regiunii inferioare a lamboului tendinos, care este ridicat, rotit în direcţia proximală a pediculului vascular integru şi plasat în defectul menţionat al regiunii infrapatelare, după care capetele lamboului tendinos sunt introduse în breşele sagitale ale fragmentelor tendonului patelar şi suturate, iar plaga este suturată pe straturi. The essence of the invention consists in performing a Doppler examination with the establishment of the projection of the vessels, then two curved incisions are made along the inner edge of the tibia in the proximal direction, which begin 6 cm above the tip of the medial malleolus, forming an ellipsoidal flap, the first incision being directed with the concavity in the medial part along the lateral edge of the Achilles tendon, and the second directed with the concavity in the lateral part, the covering fascia, the Achilles tendon and the saphenous vascular pedicle are highlighted, the flap, having a width of 2 cm, a length of 12 cm and a thickness of 3 mm, is composed of the skin, the covering fascia with the vascular pedicle and the tendon flap made up of the quadrilateral portion of the medial part of the Achilles tendon, then the incision of the lower region of the tendon flap is made, which is raised, rotated in the proximal direction of the intact vascular pedicle and placed in the aforementioned defect of the infrapatellar region, after which the ends of the tendon flap are inserted into the sagittal gaps of the patellar tendon fragments and sutured, and the wound is sutured in layers.
Rezultatul constă în refacerea deplină a integritaţii anatomo-fiziologice şi funcţionale a tendonului patelar şi a ţesuturilor supraiacente. The result is the full restoration of the anatomical, physiological and functional integrity of the patellar tendon and the overlying tissues.
Avantajele metodei constau în utilizarea lamboului insular cutaneo-fascio-tendinos pe pedicul vasculonervos cu restabilirea deplină anatomo-fiziologică a tendonului patelar şi a ţesuturilor supraiacente. The advantages of the method consist in the use of the cutaneous-fascio-tendinous island flap on the neurovascular pedicle with full anatomical-physiological restoration of the patellar tendon and overlying tissues.
Exemplu de realizare a invenţiei Example of embodiment of the invention
Metoda de plastie vascularizată a defectelor septice de tendon patelar constă în aceea că se efectuează examenul doplerografic cu stabilirea proiecţiei vaselor, apoi se efectuează două incizii curbate de-a lungul marginii interne a tibiei în direcţie proximală, care încep la 6 cm deasupra vârfului maleolei mediale, formând un lambou elipsoidal, prima incizie fiind îndreptată cu concavitatea în partea medială de-a lungul marginii laterale a tendonului achilian, iar a doua îndreptată cu concavitatea în partea laterală, se evidenţiază fascia de inveliş, tendonul achilian şi pediculul vascular safen, lamboul, având lăţimea de 2 cm, lungimea de 12 cm şi grosimea de 3 mm, este compus din cutaneu, fascia de înveliş cu pedicul vascular şi lamboul tendinos alcătuit din porţiunea patrulateră a părţii mediale a tendonului achilian, apoi se efectuează incizia regiunii inferioare a lamboului, care este ridicat, rotit în direcţia proximală a pediculului vascular integru şi plasat în defectul menţionat al regiunii infrapatelare, după care capetele lamboului tendinos sunt introduse în breşele sagitale ale fragmentelor tendonului patelar şi suturate, iar plaga este suturată pe straturi. The vascularized plasty method of septic patellar tendon defects consists in performing a Doppler examination with the establishment of the projection of the vessels, then two curved incisions are made along the inner edge of the tibia in the proximal direction, which begin 6 cm above the tip of the medial malleolus, forming an ellipsoidal flap, the first incision being directed with the concavity in the medial part along the lateral edge of the Achilles tendon, and the second directed with the concavity in the lateral part, the covering fascia, the Achilles tendon and the saphenous vascular pedicle are highlighted, the flap, having a width of 2 cm, a length of 12 cm and a thickness of 3 mm, is composed of the skin, the covering fascia with the vascular pedicle and the tendinous flap made up of the quadrilateral portion of the medial part of the Achilles tendon, then the incision of the lower region of the flap is performed, which is raised, rotated in the proximal direction of the intact vascular pedicle and placed in the aforementioned defect of the infrapatellar region, after which the ends of the tendon flap are introduced into the sagittal gaps of the patellar tendon fragments and sutured, and the wound is sutured in layers.
Exemplu de aplicare a invenţiei Example of application of the invention
Bolnavul Lungu Ş., anul naşterii 1961, a fost spitalizat în secţia ortopedie şi traumatologie a Institutului de Medicină Urgentă cu diagnosticul: Inflamaţia plăgii postoperatorii cu necroză şi deficit de tegumente şi al tendonului propriu al patelei. Pacientul a fost operat folosind metoda propusă. Patient Lungu Ş., born in 1961, was hospitalized in the orthopedics and traumatology department of the Institute of Emergency Medicine with the diagnosis: Inflammation of the postoperative wound with necrosis and deficiency of the skin and the patellar tendon itself. The patient was operated on using the proposed method.
Intervenţia a fost efectuată cu succes la pacienţii internaţi în Clinica Chirurgie Plastică, Reconstructivă şi Microchirurgia Locomotorului a Institutului de Medicină Urgentă, Catedra Ortopedie şi Traumatologie a USMF “Nicolae Testemiţanu“, ca rezultat s-a obţinut restabilirea anatomo-funcţională deplină a membrului afectat. The intervention was successfully performed on patients admitted to the Plastic, Reconstructive Surgery and Locomotor Microsurgery Clinic of the Institute of Emergency Medicine, Department of Orthopedics and Traumatology of the "Nicolae Testemiţanu" University of Medicine and Pharmacy, as a result of which the full anatomical and functional restoration of the affected limb was achieved.
1. Clement Baciu. Chirurgia şi protezarea aparatului locomotor. Bucureşti, Ed. medicală, 1986, 393 p. 1. Clement Baciu. Surgery and prosthetics of the locomotor system. Bucharest, Medical Publishing House, 1986, 393 p.
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Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20150019A MD976Z (en) | 2015-02-19 | 2015-02-19 | Method for angioplasty of patellar tendon septic defects |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| MDS20150019A MD976Z (en) | 2015-02-19 | 2015-02-19 | Method for angioplasty of patellar tendon septic defects |
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| Publication Number | Publication Date |
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| MD976Y MD976Y (en) | 2015-12-31 |
| MD976Z true MD976Z (en) | 2016-07-31 |
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| MDS20150019A MD976Z (en) | 2015-02-19 | 2015-02-19 | Method for angioplasty of patellar tendon septic defects |
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Citations (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| SU1428362A1 (en) * | 1985-07-12 | 1988-10-07 | А. И. Хабаров | Method of plasty of tendons |
| RU2142749C1 (en) * | 1996-03-18 | 1999-12-20 | Голубев Игорь Олегович | Method for carrying out plastic repair of finger flexor tendons |
| RU2158115C2 (en) * | 1998-06-24 | 2000-10-27 | Алтайский государственный медицинский университет | Method for correcting stable extension hip joint contractures |
| MD2257G2 (en) * | 2003-03-05 | 2004-03-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method of talocrural joint arthrodesis with vascularized fibular osseous fragment |
| MD2277G2 (en) * | 2003-07-07 | 2004-05-31 | Григоре ВЕРЕГА | Method of shank plastic amputation |
| MD2376G2 (en) * | 2003-08-11 | 2004-08-31 | Григоре ВЕРЕГА | Method of sacral defect plasty |
| MD3042G2 (en) * | 2004-08-09 | 2007-01-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method of elongating the vascular pedicle for the medial plantar flap displaced by the Y-V technique |
| RU2340301C2 (en) * | 2007-02-05 | 2008-12-10 | Государственное образовательное учреждение дополнительного профессионального образования "Новокузнецкий государственный институт усовершенствования врачей Федерального агентства по здравоохранению и социальному развитию" | Method of achilles tendon plasty |
| RU2391065C1 (en) * | 2009-03-10 | 2010-06-10 | Федеральное государственное учреждение "Уральский научно-исследовательский институт травматологии и ортопедии имени В.Д. Чаклина Федерального агентства по высокотехнологичной медицинской помощи" | Method of treatment of old lacerations of extensor apparatus of knee joint |
| MD332Z (en) * | 2010-10-07 | 2011-09-30 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method of tibia pseudoarthrosis plasty with a vascularized graft |
| MD666Z (en) * | 2013-02-12 | 2014-03-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method for plastic surgery with vascular graft of the Achilles tendon defect |
-
2015
- 2015-02-19 MD MDS20150019A patent/MD976Z/en not_active IP Right Cessation
Patent Citations (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| SU1428362A1 (en) * | 1985-07-12 | 1988-10-07 | А. И. Хабаров | Method of plasty of tendons |
| RU2142749C1 (en) * | 1996-03-18 | 1999-12-20 | Голубев Игорь Олегович | Method for carrying out plastic repair of finger flexor tendons |
| RU2158115C2 (en) * | 1998-06-24 | 2000-10-27 | Алтайский государственный медицинский университет | Method for correcting stable extension hip joint contractures |
| MD2257G2 (en) * | 2003-03-05 | 2004-03-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method of talocrural joint arthrodesis with vascularized fibular osseous fragment |
| MD2277G2 (en) * | 2003-07-07 | 2004-05-31 | Григоре ВЕРЕГА | Method of shank plastic amputation |
| MD2376G2 (en) * | 2003-08-11 | 2004-08-31 | Григоре ВЕРЕГА | Method of sacral defect plasty |
| MD3042G2 (en) * | 2004-08-09 | 2007-01-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method of elongating the vascular pedicle for the medial plantar flap displaced by the Y-V technique |
| RU2340301C2 (en) * | 2007-02-05 | 2008-12-10 | Государственное образовательное учреждение дополнительного профессионального образования "Новокузнецкий государственный институт усовершенствования врачей Федерального агентства по здравоохранению и социальному развитию" | Method of achilles tendon plasty |
| RU2391065C1 (en) * | 2009-03-10 | 2010-06-10 | Федеральное государственное учреждение "Уральский научно-исследовательский институт травматологии и ортопедии имени В.Д. Чаклина Федерального агентства по высокотехнологичной медицинской помощи" | Method of treatment of old lacerations of extensor apparatus of knee joint |
| MD332Z (en) * | 2010-10-07 | 2011-09-30 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method of tibia pseudoarthrosis plasty with a vascularized graft |
| MD666Z (en) * | 2013-02-12 | 2014-03-31 | Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова | Method for plastic surgery with vascular graft of the Achilles tendon defect |
Non-Patent Citations (1)
| Title |
|---|
| Clement Baciu. Chirurgia şi protezarea aparatului locomotor. Bucureşti, Ed. medicală, 1986, 393 p. * |
Also Published As
| Publication number | Publication date |
|---|---|
| MD976Y (en) | 2015-12-31 |
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