RU2371144C1 - Method of treating inguries of hip joint in small pets - Google Patents

Abstract

FIELD: veterinary.

SUBSTANCE: method consists in performing stable fastening and reposition of anatomic structures of hip joint and/or its fragments by compression-distraction apparatus. An stage of fixiation during 10 days glutoxim in therapeutic doze 3 mg/kg is introduced.

EFFECT: method allows reducing of probability of osteoarthrosis emergence in distant terms after anatomic-functional restoring of joint.

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Description

The invention relates to veterinary surgery, namely to traumatology and orthopedics of animals, and can be used in the treatment of traumatic injuries of the hip joint in small pets.

A known method of osteosynthesis of the hip joint in case of damage to animals, providing for the reposition and stable fixation of the anatomical structures of the hip joint and / or their fragments using a compression-distraction apparatus (RF Patent No. 2197920, publ. 02.10.03).

However, this method does not exclude the likelihood of developing manifestations of osteoarthritis of the hip joint after its anatomical and functional recovery in the long-term follow-up.

A known method for the treatment of pathology of the hip joint, in particular Legg-Calve-Perthes disease, in which, along with orthopedic reconstruction, including reposition and fixation of the anatomical structures of the hip joint, the patient is prescribed a course of drug therapy. The indicated course of treatment provides, depending on the stage of treatment, the administration of drugs: muscle relaxants, chondroprotectors, and bone resorption inhibitors (RF Patent No. 225688, published on July 10, 2005, Bull. No. 19, “A Method for the Treatment of the Early Stage of Hip Osteochondropathy”).

However, this method has a highly specialized orientation, due to the pathogenesis of aseptic necrosis of the thigh, and its use in the treatment of injuries of the hip joint in domestic animals is impractical. To a large extent this is due to the specifics of the development of the traumatic process in its early stages, in which the use of chondroprotective drugs and resorption inhibitors is usually ineffective.

The objective of the invention is to develop a method for the treatment of damage to the hip joint in small pets, which reduces the likelihood of developing manifestations of osteoarthritis in the long term after the anatomical and functional joint restoration.

This problem is solved by the fact that in the method of treating hip joint injuries in small domestic animals, including stable fixation and reposition of the anatomical structures of the hip joint and / or its fragments with the help of a compression-distraction apparatus in combination with conducting medical therapy courses, at the fixation stage during For 10 days, immunomodulators of systemic cytoprotective action are administered in a therapeutic dose corresponding to the live body weight of the animal.

The method is illustrated by the description, examples of practical use, as well as illustrative material.

Figure 1 - X-ray of the animal's hip joint before treatment. Transverse fracture of the joint cavity on the right with the displacement of fragments.

Figure 2 - X-ray of the hip joint of the animal during treatment.

Figure 3 - X-ray of the hip joint of the animal 2 years after treatment. Signs of osteoarthritis are not observed.

Figure 4 - Radiograph of the animal's hip joint before treatment. Transverse fracture of the joint cavity on the right with the displacement of fragments.

Figure 5 - X-ray of the hip joint of the animal during treatment.

6 - X-ray of the animal's hip joint 1 year after treatment. The presence of signs of coxarthrosis.

The method is as follows.

In the operating room, after premedication and anesthesia, osteosynthesis of the anatomical area of the pelvis and hip joint is performed by known techniques on the side of the lesion. In the course of its implementation, based on the data of x-ray studies, based on the type of joint damage (fracture, dislocation, fracture-dislocation, and other types of damage), through the sections of the pelvic bones adjacent to the joint damage zone, as well as their individual fragments, the required number of external clamps of spoke and rod types, which are mounted on external supports installed at the appropriate level in the form of arcs or half rings. The latter, with the help of threaded rods and hinge assemblies, are interconnected with the possibility of a dosed multi-plane movement.

By displacement of the apparatus supports relative to each other, as well as by tension or by shifting the fixing elements, the anatomical structures of the hip joint are repositioned, achieving an exact comparison of fragments of the bones of the articular cavity and / or reduction of dislocation.

At the final stage of the operation, control radiography is performed and, if necessary, after open reduction, layer-by-layer suturing of the surgical wound is performed. Further, the subsystems of the device are stabilized.

In the postoperative period, until the fragments of the articular cavity are completely consolidated in the damage zone and / or a reliable x-ray picture of the dislocation is obtained, stable fixation of the anatomical region of the hip joint is carried out. Moreover, in some cases, using the appropriate hinge nodes, they retain the function of the hip joint.

At the same time, to prevent the development of manifestations of osteoarthritis, starting from 8-12 days after surgery, for 10 days the animal is given a course of drug therapy with a systemic cytoprotective effect immunomodulator, which is prescribed in a therapeutic dose corresponding to live body weight. As such a preparation, in particular, Glutoxim can be used, the therapeutic dose of which is 3 mg per 1 kg of animal weight.

After obtaining a reliable picture of the consolidation of the fracture and / or stable reduction of dislocation, the apparatus is dismantled.

The practical implementation of the method is illustrated by the following clinical examples.

Example 1. Dog, age 1 year 6 months. Transverse fracture of the articular cavity to the right with the displacement of fragments (Figure 1).

In the operating room, a complete reposition of fragments of damaged bones and external fixation of the pelvic ring and the right pelvic limb by compression-distraction apparatus were performed.

Fixing knitting needles passed through the body and spinous process of the seventh lumbar vertebra and the ilium wings, and retainer rods through the sacroiliac joints and iliac wings. Their outer ends are fixed on the "base" support of the apparatus. Then, the right femur was fixed with retainers of the spoke and rod types, passing them through the distal third of the thigh. Having fixed the outer ends of the clamps on the external support, the latter was connected to the “base” support using threaded rods and hinge assemblies. After that, the external clamps of the spoke and rod type were cantilevered extra-articulously, towards each other, into the joint cavity: into the caudal and cranial divisions of the acetabular region and secured indirectly through brackets and straps to the adjacent support. The operation was completed by performing control radiography, suturing the wound and stabilizing the systems of the apparatus.

Within 28 days, stable fixation of the anatomical region of the hip joint was performed by the apparatus (Figure 2). Moreover, starting from 10 days after the operation, for 10 days, the animal was given a course of drug therapy with the appointment of Glutoxim in a therapeutic dose of 3 mg per 1 kg of body weight. Upon receipt of a reliable picture of fracture consolidation, the apparatus was dismantled.

At the time of dismantling the apparatus, the condition of the animal was satisfactory. Pelvic limb support ability restored on the damage side. Joint function - in full. There was no soreness in the anatomical region of the joint.

At the control examination after 2 years, the achieved anatomical and functional result is preserved, there are no signs of osteoarthrosis of the right hip joint (Figure 3).

Example 2. Dog, age 2 years. Transverse fracture of the articular cavity to the right with the displacement of fragments (Figure 4).

In the operating room, a complete reposition of fragments of damaged bones and external fixation of the pelvic ring and the right pelvic limb by compression-distraction apparatus were performed.

Osteosynthesis was performed according to the method described above with the fixation of the pelvis and the anatomical region of the hip joint with the help of a compression-distraction apparatus using fixators of the spoke and rod types. The operation was completed by performing control radiography, suturing the wound and stabilizing the systems of the apparatus.

Within 42 days, external stable fixation of the anatomical region of the hip joint was performed using the apparatus (Figure 5). No drug therapy has been performed. Upon receipt of a reliable picture of fracture consolidation, the apparatus was dismantled.

At the time of dismantling the apparatus, the condition of the animal was satisfactory. The pelvic limb support ability was restored on the side of the hip joint damage. Joint function - in full.

At the follow-up examination after 1 year there was a restriction of mobility, a painful reaction in the anatomical region of the right hip joint. X-ray: periosteal reaction in the acetabular region, the femoral head and neck, osteophytes and slight deformation of the articular cavity and femoral head, which indicated the development of coxarthrosis (Figure 6).

Using the proposed method in veterinary practice showed that its application provides good anatomical and functional results in the treatment of damage to the hip joint by reducing the likelihood of developing manifestations of osteoarthritis in the long term after the anatomical and functional restoration of the joint.

Claims (1)

A method for treating hip joint injuries in small domestic animals, including stable fixation and reposition of the anatomical structures of the hip joint and / or its fragments using a compression-distraction apparatus in combination with medical therapy courses, characterized in that they are administered at the fixation stage for 10 days Glutoxim immunomodulator systemic cytoprotective action in a therapeutic dose of 3 mg / kg

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