RU1816437C - Treatment method of disorder of collateral ligaments of knee joint - Google Patents

Abstract

Usage: in medicine, in particular in traumatology, orthopedics in the treatment of injuries of collateral ligaments of the knee joint. The goal is to improve the stability of the knee joint. SUBSTANCE: bone-tendon allografts are formed from a ligament of a patella with bone fragments from a trapezoidal patella, from a tibial tuberosity of a rectangular shape, allo-ligation is connected with the inner surface to the joint capsule, and the trapezium-shaped trapezoidal canals are fixed and fixed by jamming them; distal metaphysis of the thigh, rectangular grafts are placed in the kamalas of the tibial metaphysis formed according to their shape th and the fibular head and fix their x pins of compact bone, sutured allosv safety relay to the joint capsule in the projection of the attachment of the menisci. Positive effect: prevention of recurrence of instability of the knee joint. ate with

Description

The invention relates to medicine, in particular to traumatology, orthopedics in the treatment of injuries of collateral ligaments of the knee joint.

The aim of the invention is to improve the stability of the knee joint.

The method of plasty of collateral tibial ligament is carried out as follows.

A bone-tendon allo block is taken from the patella, ligament of the patella and tuberosity of the tibia. A bone fragment from a patella is formed of a trapezoidal shape with a wide free end, a bone fragment of a rectangular shape is formed from the tuberosity of the tibia. The dimensions of the trapezoidal bone fragment: the width of the free

end 15-17 mm; the width of the end associated with the tendon is 10-12 mm; length 20-25 mm; height is 3 mm.

The dimensions of the rectangular bone fragment are 8–10 mm wide, 12–15 mm long, and 2 mm high; the tendon part of the bone-tendon block has a width equal to the width of the rectangular bone fragment.

A longitudinal section above the attachment site of the collateral tibial ligament exposes the medial condyle of the femur and tibia. The second incision on the outer surface exposes the outer condyle of the thigh. With a 3.0 mm drill in the distal metaphysis of the thigh, three channels are drilled from the outside inside in a horizontal plane, converging

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with each other at the site of attachment of the collateral tibial ligament on the thigh. Connecting these channels with each other, form a single channel of a trapezoidal shape. At the place of attachment of the collateral ligament on the internal epicondyle of the tibia, a niche of a rectangular shape, respectively, a rectangular bone fragment of the bone of the o-tendon block is formed with a chisel.

A bone-tendon block is passed through the canals formed in the distal metaphysis of the thigh, inside the DVV inside the bone, and drawn to the rectangular niche on the tibia. The graft is placed on the inner surface of the joint capsule. At the same time, the trapezoidal bone fragment is firmly fixed to the walls of the canal in the metaphysis of the femur and fills it. A rectangular bone fragment is inserted into the niche of the metaphysis of the tibia in a taut state and fixed with a separate bone pin made of compact bone. The joint capsule in the meniscus attachment projection is sutured with three interrupted sutures to the tendon portion of the graft. Wounds are sutured tightly. Immobilization is carried out by the posterior plaster cast from the fingertips to the annual fold for 3 weeks.

The method of plasty of collateral fibular ligament is carried out as follows.

A trapezoidal channel is formed in the distal metaphysis of the thigh with a wide aperture inwards, and a narrow one outwards. The bone-tendon block is carried out by a bone fragment of a rectangular shape through the canal on the thigh from the inside outwards, this bone fragment is brought to the channel of a rectangular form on the head of the fibula, formed in the sagittal plane from top to bottom. Submerging a rectangular bone fragment into this canal, the tendon part of the block is pulled. A hole is formed with an awl in the head of the fibula from the outside of the inside, through both walls of the rectangular canal and the bone fragment located in it. We drive a bone pin from a compact bone into this hole, the bone fragment is firmly fixed in the channel. The graft is placed on the inner surface of the joint capsule. The meniscus attachment projection capsule is sutured with three interrupted sutures to the tendon portion of the graft.

Example. Patient M. was admitted 6 months later after an injury with complaints of pain

and instability in the right knee joint. Plastic surgery of the collateral fibular ligament of the right knee joint was performed according to the proposed method. A bone-tendon alloblock was taken from the patella, ligament of the patella and tuberosity of the tibia. A bone fragment from the patella is formed of a trapezoidal shape with a wide free end; a rectangular bone fragment is formed from the tuberosity of the tibia. The dimensions of the trapezoidal bone fragment: the width of the free end of 15-17 mm, the width of the end,

associated with the tendon 10-12 mm, length 20-25 mm, height 3 mm. The dimensions of the rectangular fragment: width 8–10 mm, length 12–15 mm, height 2 mm; the tendon part of the bone-tendon block had a width equal to the width of the rectangular bone fragment. The method of plasty of the collateral peroneal ligament was carried out as follows: a trapezoidal channel is formed in

distal metaphysis of the thigh with a wide aperture inwards, narrow - outwards. The bone-tendon block is held by a bone fragment of a rectangular shape through the canal on the thigh from the inside outwards;

this bone fragment to the canal of a rectangular shape on the head of the tibia, formed in the sagittal plane from top to bottom. Submerging a rectangular bone fragment into this canal, the stretched tendon part of the block. With an awl, a hole is formed in the head of the fibula from the outside of the inside, through both walls of the rectangular canal and the bone fragment located in it. Driving in and this hole

the bone pin is made of compact bone, the bone fragment is firmly fixed in the canal. The graft has an inner surface located on the joint capsule. The capsule in the projection of the attachment of the meniscus was hemmed

three interrupted sutures to the tendon of the graft. The postoperative period without complications. Immobilization 3 weeks. Load 1.5 months after surgery. After 4 months, he returned to sports. Examined 0.5 years after surgery: no complaints, joint stable - no pathological deviation of the tibia outwardly.

Claims (1)

The claims A method for treating injuries of collateral ligaments of the knee joint by forming bone-tendon allografts from the ligament of the patella with bone fragments of the patella and tuberosity of the tibia, installing allo-ligament with the inner surface of the joint capsule and fixing it with bone fragments in the formed channels of the corresponding shape on the distal metaphysis of the thigh and in the canals on the tibia and the head of the fibula with their additional fixation with pins, characterized in that, with 0 In order to improve the stability of the knee joint, the bone fragments of the allograft are made from a trapezoidal patellar, and from the tuberosity of the tibia of a rectangular shape, the trapezoidal graft is fixed by jamming, rectangular grafts with pins from a compact bone, and the joint is snapped to the capsule .