RU1814883C - Method for treatment of deforming gonarthrosis - Google Patents

Abstract

Usage: in medicine, in orthopedics in the treatment of deforming gonarthrosis. Goal: reduce tissue trauma. Essence: after a high supra-alkaline osteotomy of the tibia and ventralization of the tuberosity, the tibia with a ligament above the knee, the fragments are fixed using one of the generally accepted methods (knitting needles, screws, plates, etc.). Ventralization of the tibial tuberosity is achieved by laying together the bone autologous and demineralized ligature allografts in the tuberosity tuberculosis, the autograft being taken from the osteotomy of the tibia and the resulting defect will be replaced by the demant. Positive effect: a method of treating deforming gonarthrosis provides a reduction in the invasiveness of an operation, its duration, and a reduction in risks. postoperative. -,; nausea, reduction of treatment duration, improvement of functional cosmetic treatment results. - 45

Description

The invention relates to medicine, namely to traumatology and orthopedics.

The purpose of the invention is to improve the functional and cosmetic result ... of treating patients with deforming toiarthrosis. elimination of additional operational trauma when taking a bone autograft from the iliac crest, elimination of the conditions for the development of vascular, neurological complications, necrosis of the skin in the area of tuberosity, the occurrence of postoperative hernias.

The method is as follows

S-shaped oblique-transverse incision at the level of tuberosity sub-subcutaneous bare tibia. A hinge or wedge-shaped osteotomy is performed for more than the 5th bones above the place of attachment of the patellar ligament, correction of the o. with the lower extremity is carried out — it fixes the fragments in one of the generally accepted methods (spokes, angular plates, bolts, stitches, etc.). To facilitate correction of the axis of the limb, an additional fragment of the tibia 1 to 1.5 cm long, used as an autotransplant, is resected through an additional incision along the outer surface in in / 3. The defect formed in the fibula. the bones are replaced with a demineralized bone-graft, the wound is sutured smoothly. Cut off the site of attachment of the ligament of the patella with cortical PLP00

with

with

with an abutment, flap, longitudinally the front edge of the tibia, 8–10 cm long. Bone auto- and demineralized allografts are placed in a split with the expectation that the attachment site of the patella ligament should be shifted anteriorly by 1–1.5 cm and fixed with a screw or Kirschner spokes for the distal fragment of the tibia. In the postoperative period, the immobilization of the plaster cast from the tips of the fingers to the thigh 3 is continued for 10-12 weeks, physiotherapy exercises and physiotherapy are carried out; dosed load on the operated limb is allowed after b - 8 weeks.

The fundamental difference from the prototype is the use of the osteotomy of the fibula, made to facilitate the correction of varus deformity of the leg, to take the bone autograft, the absence of the need to take the graft from the iliac crest, the use of demineralized allografts to replace the defect of the fibula and as a plastic material, an interponing fragment of the tibia.

This method operated on 2 patients,

An example of the method: patient T., 57 years old, was under treatment for deforming gonarthrosis of 3 tbsp .; considers herself a patient1 for 10 years, severe pain in the right knee joint bothered, range of motion - flexion to 70 °, extension to 180 °,

The operation was performed - corrective osteotomy of the tibia, Ferguson's operation according to the proposed method. Primary healing. The gypsum dressing lasted up to 10 weeks, then a course of rehabilitation treatment was carried out.

load is allowed from 8 weeks after surgery. After 5 months, the patient notes the subsidence of pain with a saved range of movements in the rights, knee joint, good debatability of the lower limb,

Thus, the proposed method for the treatment of goyarthrosis in combination of distinctive features gives a new positive effect:

The morbidity and duration of the surgical aid are reduced.

The causes of postoperative complications (hernias of postoperative scars after taking bone grafts from the ileum) are eliminated.

crest, neurological, vascular complications of the lower limb, skin necrosis in the region. tibial tuberosity),

Claims (1)

The method of treatment of deforming gonarthrosis by means of submandibular osteotomy of the tibia, correction of the segment axis, anterior displacement of the tibial tuberosity with placement under the tuberosity of the bone graft, followed by fixation, characterized in that, to reduce tissue trauma, the bone graft forms the upper graft bones, additionally placed under the tuberosity of a demineralized allograft, a defect of the fibula is replaced by a demineralized m bone ellotransp- lanthanum.