RU1827206C - Arthroplasty method - Google Patents

Abstract

Application: in orthopedics. Goal: increase the range of motion in the joint. Essence: articular surfaces are resected, holes are formed in one of the metaphyses. reinforced with dacron threads of zlupupovin, impose it on one of the articular surfaces, placing the threads of the axis of rotation of the joint with their subsequent fixation. Benefit: trophicity of recovered articular surfaces improves.

Description

The invention relates to medicine, namely to traumatology and orthopedics, and can be used in the treatment of stiffness and joint ankylosis.

The aim of the invention is to increase the range of motion in the joint.

This is achieved by pre-stitching allopupovin with lavsan threads, laying it on one of the articular surfaces, placing the threads along the axis of rotation of the joint.

The method is carried out as follows.

15-20 days before the operation, an allogeneic umbilical cord is prepared with a length equal to the surface of the operated joint. Dissect it longitudinally, remove vascular inclusions. The umbilical cord is flattened until it acquires a flat surface. Then it is reinforced with lavsan thread with a diameter of 2 mm. The reinforced material is immersed for preservation in a 0.5% formalin solution and left for 12-15 days.

The joint alkiza is separated. Economical resection of the articular ends

with their subsequent modeling. On one of the bones of the joint, usually the upper segment, at the level of the metaepiphysis, i.e. at the level of transition of the bone to the cartilaginous surface, several channels are made in the sagittal plane.

The prepared reinforced umbilical cord is placed on the articular surface. At the same time, the ends of the polyester filament on the umbilical cord are passed through the bone channels and tied with strong knots.

The joint is carefully drained and the wound is sutured in layers tightly. Gypsum dressing is applied and moderate stretching is established. On the 5-6th day after the operation, the development of movements in the joint begins.

Example 1. Patient K.Kh., 29 years old, was admitted to the clinic TeshGosMI No. 1.

East disease number 33706. Diagnosis: rheumatoid arthritis, articular form, act. I Art. FN {II Art. ankylosis of the right elbow joint. Operation No. 465 of 12/27/89. Under anesthesia, a longitudinal incision was made along the posterior surface of the right elbow

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of the Langenberk charter, 12 cm long. The triceps muscle is separated from the bone at the level of its tendon in the form of a tongue (according to the method of V.P. Pavlov). The ulnar joint is exposed. After the ankylosis of the joint is separated using a chisel and a bone knife, an economical resection of the joint ends of the humerus and ulna is performed. At the level of the supracondylar of the humerus, 6 channels are visible from front to back. The distal end of the humerus is covered with a prepared canned umbilical cord framed with lavsan thread. The ends of the umbilical cord reinforcing threads are passed through the canal of the humerus from back to front and are tightly tied. The articular ends of the humerus and ulna are checked for adaptation. The wound is thoroughly washed with antiseptics. Chlorovinyl drainage is carried out along the posterior-outer surface of the forearm. The wound is sutured in layers tightly. The seam is treated with iodine. Impose an antiseptic dressing. The Volkov-Oganes articulated distraction apparatus is then applied to implement the development of movements in the joint and provide reliable diasthesis to the area of the newly created joint gap.

Example 2. Sick S.X. East. disease number 30920. diagnosis: rheumatoid arthritis, articular form, act. I Art. FN III Art. ankylosis of both knee joints. Operation of December 7, 89 No. 423. Under anesthesia, we will make a medial parapatellar incision according to Payr 15 cm long. The capsule of the joint is exposed in layers. It is sharply atrophic, incremented by the underlying tissue. The upper valve of the knee joint is completely covered with commissures. The articular fissure is not visible. Gradually, the ankylosis of the joint is disconnected using a chisel and a bone knife. An economical resection of the articular ends of the femur and tibia is performed to give them an appropriate shape. Diastasis is created between the articular ends of the bones by 0.5 cm. The patella is shaped accordingly. At the distal end of the femur at

condyles carry out channels in the sagittal plane. Then, the previously prepared allogeneic canned umbilical cord is placed on the articular end of the femur. When the knee joint is maximally bent, the umbilical cord reinforcing threads are guided through pre-made channels into the bones from back to front and connected along the front surface of the thigh

strong knots. Capsulotomy and (Z-shaped tenomyotomy of the biceps femoris muscle) are performed to remove the posterior flexion of the knee joint.

vinyl chloride drainage system. The wound is sutured in layers tightly. The seam is treated with iodine. Aseptic and then plaster casts are applied.

The positive effect of using the proposed method is that it provides for the use of allogeneic canned umbilical cord, as one of the types of connective tissue rich in mucopolysaccharides, due to the properties of which trophic tissue improves and, therefore, the regeneration of cartilage tissue is activated.

In addition, the use of an umbilical cord reinforced with dacron thread and fixing it with the left ends of the threads on one of the joint surface, placing the umbilical cord so that the direction of the stitches coincides with the axis of the bone, increases the reliability of optimal diastasis.

Claims (1)

SUMMARY OF THE INVENTION A method of arthroplasty by resecting articular ends, forming holes in one of the metaphyses, passing through them between the articular surfaces of mylar threads with subsequent fixation, characterized in that, in order to increase the range of motion in the joint, the allopaupe is pre-stitched with lavsan threads; it is laid on one of the articular surfaces, placing the threads along the axis of rotation of the joint.