RU1773388C - Method for treatment of osteochondropathy of femur head - Google Patents

Abstract

Usage: in medicine, namely in orthopedics in the treatment of osteochomdropagia of the femoral head, The goal is to prevent contracture in the joint. Essence: from the wing of the ilium with the anteroposterior spine and the place of attachment of the tailor muscle, a non-free transplant is formed equal to the thickness of the ilium, and in the supraclavicular region there is a corresponding groove about which the formed graft is inserted. Positive effect: bringing an additional power source to the acetabulum during dysplasia prevents contact in the joint and shortens the treatment time.

Description

The invention relates to medicine, in particular to orthopedics and traumatology in the treatment of femoral head osteochondropathy.

There are various methods of treating osteochondropathy of the femoral head by means of stimulating operations — introducing autografts on the feeding muscle legs into the neck and head (E.I., Shairo - J. Orthoped, traumatol. 1968, No. 7, pp. 48-53, V.L. Andrianov and E.S. Tikhonenko. - copyright certificate No. 1268155, B.I. No. 41 for 198G). The essence of these operations is to take an autograft - a pin from the proximal part of the thigh with the broad muscle of the thigh attached to it in the first method (E.I. Shairo) or the front portion of the middle annual muscle - in the second method (V.L. Andrianov and E.S. Tikhonenkov) and its introduction into the tunnel made in the D neck and femoral head.

There is also a method of treating degeneration of the neck and head of the femur, including, and Perthes disease (V.L. Andrianov,

E.S. Tikhonenkov and M.N.Kharlamov - a positive decision to obtain a copyright certificate dated February 26, 88, by application N 3920097) 14/071048 (with priority dated May 21, 85) taken as a prototype. In this method, a bone graft is cut out from the proximal femur in the form of a pin with the broad muscle of the thigh attached to it and the front portion of the middle annual muscle with the tunnel inserted into its neck and head.

The disadvantage of all of the above methods, including the prototype, is the invasiveness of the operation, various possible complications leading to limited mobility in the joint, closure of the sprouting zone and insufficient nutrition of the articular cartilage of the head and neck of the thigh with a cortical graft, surgical trauma to the affected femoral head.

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The aim of the invention is to prevent articular contracture and reduce treatment time,

The method is carried out as follows.

After opening soft tissues, a part of the ilium wing is isolated subperiostally, along with the anteroposterior spine and the tailor muscle attached to it. 2x4 cm). The tailor muscle is mobilized along with the graft and temporarily wrapped in a tissue moistened with saline. Then, the antero-lateral edge of the supraverticular area of the hollow is subperiostally, and a groove equal to the thickness of the graft is made in it at a distance of 1 cm from the place of attachment of the capsule. The depth of the groove reaches the inner cortical plate of the ilium, and the length to the posterior edge of the cavity. The groove configuration should be consistent with the existing ecf of the natural concavity of the iliac wing graft. The migrating musculoskeletal tissue complex is freed from the tissues and the graft is inserted into the groove along with the tailor muscle attached to it and the vessels and nerves passing through it 8. The wound is sutured in layers. Plaster cast is imposed. Immobilization is created by fixing the limb on the Beller splint with slight flexion in the knee joint and hip for 2 weeks, at the same time restorative and restorative treatment is prescribed. Joint function does not suffer after surgery. After 3 months, walking on crutches is allowed without resting on the operated limb.

Example. Patient A. 12 years. Diagnosis: Perthes disease in the stage of fragmentation of the head of the right thigh. On the x-ray before the operation, fragmentation of the head of the right thigh with cystic changes in the neck is noted.

Clinically, the patient has pain during exercise and movement, limitation of abduction and internal rotation.

A cut 1 cm above the anteroposterior spine and down dissected the skin, subcutaneous tissue and fascia. The lateral area of the ilium body to the posterior edge of the hollow and the ilium wing to a depth of 3 cm and 5 cm long along with the anteroposterior axis and the tailor muscle attached to it with passing vessels and nerves are subperiostally selected. WITH

using a bit, a graft of 2 x A cm was cut down. The tail muscle was mobilized from adjacent tissues along with the graft and wrapped in a gauze cloth moistened with saline.

Then, 1.0 cm indent from the place of attachment of the joint capsule in the lateral part of the supracetabular region, a groove is cut out with a chisel according to the size of the graft, which is inserted into

him so that the tailor muscle with vessels and nerves came from his anterior section. The wound is sutured in layers. An X-ray screening was performed - the graft is located in the cut-out groove above the cavity and is held therein.

The patient was laid on the Beller tire, the sutures were removed on day 12, and then the fixation was removed. General strengthening and rehabilitation treatment was prescribed.

After 3.5 months, Reagent control was performed. The restoration of the shape and structure of the femoral head is noted; the cysts in the femoral neck have disappeared. The full range of motion in the joint was restored, no pain was noted,

Claims (1)

The claims A method for treating osteochondropathy of the femoral head by introducing a non-free bone autograft into the hip joint zone, characterized in that, for the purpose of prevention articular contracture, shortening the duration of treatment, form a bone graft from the iliac wing with the anteroposterior spine and the site of attachment of the tailor muscle equal to the thickness of the iliac body bones, and a supraclavicular area - the corresponding groove. into which the formobain graft is inserted.