RU1801397C - Method for reconstruction of hip joint - Google Patents

Abstract

The invention relates to medicine, namely to orthopedics and traumatology, and to mo-. can be used to treat patients with severe forms of hip damage. The aim of the invention is to provide movement, support of the thigh while maintaining the length of the limb. SUBSTANCE: method for reconstruction of a hip joint consists in performing intertrochanteric osteostomy, cutting and abduction of the greater trochanter, removal of the affected proximal femur, performing an osteotomy over the articular fissure of the ilium with a lower flaking into the cavity of the acetabulum, which formed a defect a graft graft taken from a removable portion of the femur. Positive effect: providing movements, support while maintaining the length of the limb. ate with

Description

The invention relates to medicine, namely to orthopedics and traumatology, and can be used for the surgical treatment of diseases of the hip joint, accompanied by severe degenerative-dystrophic processes in the proximal femur, in which the resection of the hip joint, which leads to significant shortening of the hip and loss of debatability.

The aim of the invention is to provide movement and support of the thigh while maintaining the length of the limb.

The method is carried out as follows.

The soft tissues are dissected along the line connecting the anterior superior iliac network to the base of the greater trochanter and continue to cut down 7-10 cm along the outer surface of the thigh. An intertrochanteric osteotomy is performed directly above the small trochanter with excision of the iliac muscle in the lumbar muscle. Through the bone filing of the proximal femoral fragment in the sagittal plane, a large trochanter is knocked down with a wide chisel and, together with the muscles attached to it, is pulled to the side. The proximal femur is resected.

Then, the front and back walls of the acetabulum are intersected with a straight chisel, and the cortical layer for the acetabulum is cut. After that, an osteotomy of the body is carried out with a wide chisel. The ilium above the joint space in the horizontal plane to the width and depth of the acetabulum, with a chip thickness of 10-13 mm at the joint edge. In the future, we make breaking and releasing the resulting flakes in 500

about

with about

VI

the acetabular cavity is 1 / 2-2 / 3 of its diameter up to the stop in the lower edge. The wedge-shaped defect formed in the ileal body is filled with an appropriate bone graft taken from the removed proximal part of the femoral hand;

The sawdust of the femur is brought under the cleft and fixed with transosseous lavsan sutures to the remnants of the capsule of the hip joint. The greater trochanter is brought down and fixed to the diaphysis of the femur with a metal screw. The wound is drained and sutured in layers.

. Example. Patient T., 52 years old, was ill for more than 10 years. I received a fracture of the femoral neck after a traffic accident, was operated on five times, metal osteosynthesis was performed with a three-lane nail, and various bone methods were performed. plastic surgery for the formation of a false joint of the femoral neck. Fusion failed. He also received a sub-fracture after the last operation. The limb is unsupported, walks with crutches of an attack on the leg, severe pains, movements in the joint are swinging, and the limb in a vicious flexion-leading installation is disturbed.

Surgery performed: resection of the proximal femur on the left. Osteotomy of the ilium body with flaking and bone autoplasty of the defect.

The postoperative period was smooth without complication, the wound healed by primary intention. Two weeks later, the patient was raised to his legs for walking with crutches without loading the operated limb. Discharged for outpatient treatment at the place of residence, where

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sting functional recovery treatment.

Examined a year after the operation, upon receipt of complaints, there is no pain in the joint, fully loads the leg. Shortening of the left lower limb by 2 cm is noted, which is compensated by orthopedic shoes.

In the operated joint, the following range of movements: sagittal plane 0/0/70; frontal plane 15/0/15; rotational 10/0/10. .

After 10 years of break, the patient began to work in the same specialty - sho. Ferom.

Claims (1)

The claims A method for reconstructing the hip joint by means of intertrochanteric osteotomy, cutting off with the attachment point of the muscles of the greater trochanter, removing the altered proximal femur, forming a flap from the scar tissue, followed by the behavior of the end of the distal fragment, lowering the trochanter, followed by fixation, characterized in that , in order to provide movements and support of the thigh while maintaining the length of the limb, they cross the front and rear walls of the acetabulum, partially the aft layer of the bottom of the acetabulum of the hollow, osteotomy of the ileal body above the joint gap in a horizontal plane to the width and depth of the acetabulum with a chip thickness of 10 to 13 mm at the edge of the latter is performed, then it is lowered into the cavity of the acetabulum ita 1 / 2-2 / 3 its diameter, a defect in the body of the ilium is filled with a bone graft taken from the removed proximal part.