RU2008832C1 - Method for determining tendency towards corrosion and seasoning of current-conducting materials - Google Patents

Abstract

FIELD: measurement technology. SUBSTANCE: method involves taking measurements of electrochemical parameters defined as the potential difference at various points, calculating from the contact potential difference the work on escaping from the material at these points, finding out the maximum electronic work difference over these tendency towards corrosion and seasoning. EFFECT: simplified measurement procedure. 2 tbl

Description

 The invention relates to medicine, more specifically to surgical methods of treating a musculoskeletal system.

 Early surgical treatment of patients with spinal fracture and spinal cord injury is known. During the operation, the displacement of the spine is eliminated, it is stabilized by bone grafting, the use of metal structures, the application of the Ilizarov apparatus, followed by the use of corsets, gypsum cots, traction, etc. If possible, refresh the ends of the damaged spinal cord, remove brain detritus and blood clots, disconnect commissures, create patency of the subarachnoid space, produce meningo-myelo-radiculolysis. In some cases, plastic surgery of the spinal cord, dura mater is performed. In the postoperative period, they carry out drug treatment to prevent the appearance of scars and adhesions, use physical and functional measures to speed up the development of spinal automatism of urination and the act of defecation, and use the MONRO system. They carry out a set of exercises to create a muscle corset, prevent contractures in the joints of the limbs, improve trophism, and prevent and treat pressure sores.

 Despite all the above, the vast majority of patients are bedridden, in need of constant assistance. Many develop pressure sores, urocomplications, fecal stones, contact and deformities in the joints of the lower extremities, osteoparesis of bones. Paralyzed lower extremities for these patients become a burden, a brake for activation, they interfere with sitting in strollers, being more active, mobile. Patients die from physical inactivity and complications.

 The aim of the invention is to increase the effectiveness of rehabilitation measures by reducing the time of activation of the patient.

 To achieve this goal, it is proposed to rehabilitate patients with complete damage to the spinal cord in the thoracic or lumbar regions by amputating both lower limbs in the undertrochanteric region (in the upper third of the thigh) and stabilizing the thigh stumps in a position functionally beneficial for patients by forming a bone bridge between the remnants of the femur and iliac bone with an autograft taken from an amputated thigh and stabilization of the stump in the position of flexion in the hip joint at right angles to the bodies seeking.

 Amputation of paralyzed, functionally unsuitable lower limbs and “arthrodesis” (creating immobility in the hip joints) of the stumps of both thighs in a functionally advantageous position so that there are no pain and contracture in the hip joints and the remnants of the hips would serve as additional support for the movement of patients, while maintaining the joints whole , prevent complications, save the lives of patients, conduct their medical and social rehabilitation.

 The method is implemented as follows. After making sure that the spinal cord is completely and hopelessly operative, or radiologically, and having completed all the necessary procedures on the spine and spinal cord, they begin to amputate the paralyzed lower extremities and stabilize the thigh stumps in a functionally advantageous position. A two-flap skin incision is made along the anterior and posterior thighs in the upper third, preserving a sufficient musculocutaneous mass and pressing the femoral vessels under the pupartic ligament. Soft tissue pushes up. The periosteum is exactly transversely cut 3-4 cm below the small trochanter, the periosteum is peeled down. Then the bone is cut off, its edges are rounded. The nerves and blood vessels are treated accordingly. Above the end of the sawn bone, the muscles surrounding the femur are sutured together. At the same time, a full-layer free bone graft 6–7 cm long and 2–3 cm wide is taken from the amputated thigh, one end is tapered and the other is bifurcated, creating a dovetail-type emphasis. Then, a skin incision is made on the anterior surface of the thigh from the anterior superior iliac spine to the middle of the femoral stump 10 cm long, the femur and the anterior superior iliac spine are exposed. On the femur, 2-3 cm above the cut (slightly below the level of the small trochanter), a trepanation hole of a semi-oval shape 1.5 × 1 cm in size is made with a bit, where the pointed end of the bone graft is implanted. After this, the ilium is skeletonized slightly below the spine, the cortical layer is removed and a depression is made for the second bifurcated end of the bone graft. At both ends, the graft is tightly attached with transosseous silk or dacron sutures. The wound is sutured in layers, an aseptic dressing is applied.

 Exactly the same operation is carried out on the other side.

 The operation is performed without anesthesia with finger pressing of the femoral arteries and veins under aparticular ligament with mandatory transfusion of blood and blood substitutes and under the supervision of an anesthetist-resuscitator. After the operation, antibiotics are prescribed to prevent infections, after 2-3 days UHF to the wound. The patient is periodically turned over to avoid pressure sores.

 Instead of a free bone graft, you can take a bone graft on a tendon-muscle leg. To do this, with amputation of the limb, a bone graft is cut out together with the tendon-muscle leg of the gluteus maximus muscle at the site of its attachment to the outer surface of the femur in the upper third. Such a transplant, as well as a free one, is processed and attached to the femur and ilium, as described above.

 Thus, one end of the graft is inserted into the trepanation opening of the thigh stump, the other abuts against the iliac groove so that the thigh stump is at a straight (or slightly larger) bending angle with respect to the trunk. In addition, periodic spastic twitches (contractions) of the iliopsoas muscles hold the transplant in a predetermined compression (towards the femoral and iliac bones) position.

Due to the tight contact of the compact and spongy layers of the graft to the cycles of the femur and iliac bones and the good blood supply to these zones and the bone graft, especially on the tendon-muscle leg, the graft undergoes rapid fusion and adaptation. The bridge formed between the femoral and iliac bones provides immobility in the hip joints, as if creating an “arthrodesis,” that is, the stumps of the hips are stabilized in the position of flexion at an angle of about 90 ^about and leads 5-10 ^about . This is a functionally advantageous position for patients who will later move around in wheelchairs.

 2-3 weeks after the operation, the patient is activated, accustomed to independent movement in a wheelchair.

 (56) Ugryumov V.M. Surgery of the central nervous system. M.: Medicine, 1969, 2, p. 100-103.

Claims (1)

 METHOD OF REHABILITATION OF PATIENTS WITH SPINAL BRAIN INTERRUPTION by performing surgical treatment of the spine and spinal cord, characterized in that, in order to increase the effectiveness of rehabilitation measures by reducing the patient’s activation time, amputation of the lower extremities in the underwent region is additionally performed, a bridge is formed between the remnants of the femur and ileum using an autograft taken from an amputated hip and stabilize the stump in the position of flexion into the hip nnom joint at right angles to the body.