RU2404726C2 - Method for treatment of joints pathology in animals - Google Patents

Abstract

FIELD: medicine, veterinary science.

SUBSTANCE: invention relates to the field of veterinary science. Method includes installation of catheter, evacuation of joint cavity content and introduction of medicinal agents in it. At the same time joint is immobilised with the help of external fixation device, joint components are anatomically properly aligned, afterwards joint surfaces are spaced by the value that exceeds normal width of joint slot by not more than half. After installation of catheter, its working end is brought to section of joint with most explicit pathological changes. Medicamental preparations are introduced through catheter, and then after its removal, width of joint slot is normalised, and joint is fixed until integrity of its components is recovered.

EFFECT: method makes it possible to prevent injury of joint tissues in process of surgical manipulations execution.

2 cl, 4 dwg

Description

The invention relates to the field of veterinary medicine and can be used in the treatment of joint pathology in animals.

A known method of treating joints in animals, involving puncture of the joint, partial or complete removal of the contents of the joint, followed by the introduction of drugs into its cavity (General animal surgery. / S.V. Timofeev [et al.], Under the editorship of S.V. Timofeeva - M .: Zoomedlit, 2007 .-- S.482, 488-491, 502, 503, 510).

However, this method does not exclude injury to the needle of the articular surfaces, and a single injection of the drug is a complete relief of the pathological process.

A known method of treatment and diagnosis of diseases of the joints and a device for its implementation. The method involves the puncture of the joint, the removal of fluid, the installation in the punctured channel and in the joint cavity of a device such as a catheter and subsequent repeated administration of drugs. Moreover, the device contains a tubular element with a stopper, the working end of which is made in the form of a bag with capillary holes (RF patent No. 2254811, publ. June 27, 2005).

However, this method also does not exclude injury to the articular surfaces when installing the device and its removal, and also does not provide the possibility of treatment in the presence of high viscosity contents in the joint cavity. In addition, the known method does not provide for the restoration of the correct anatomical relationships and the integrity of the joint components in their pathological condition, which sharply reduces the indications for its use.

The objective of the invention is to provide the possibility of treating joint pathology, combined with a violation of the integrity and anatomically correct relationships of their components, as well as preventing injury to joint tissues in the process of performing surgical procedures.

This problem is solved by the fact that in the method, including the installation of a catheter, the evacuation of the contents of the joint cavity and the introduction of drugs into it, the joint is immobilized using an external fixation apparatus, the anatomically correct relationships of the components of the joint are restored, after which the joint surfaces are bred by no more than half the normal width of the joint space, a catheter is inserted, bringing its working end to the joint site with the most pronounced pathological changes and, medications are administered through the catheter, and then, after its removal, the width of the joint space is normalized and the joint is fixed until the integrity of its components is restored.

It is also envisaged that after conducting courses of symptomatic drug therapy, the joint is fixed with the possibility of developing active-passive movements in it.

The invention is illustrated by a description, an example of practical use and illustrative material, which shows:

figure 1 - x-ray of the pelvis of the animal before treatment, a transverse fracture of the articular cavity of the left hip joint;

figure 2 is an x-ray of the pelvis of the animal after performing osteosynthesis and installation of the catheter in the diluted articular surfaces of the left hip joint;

figure 3 - x-ray of the pelvis of the animal after completing courses of drug therapy during the development of active-passive movements of the left hip joint using an external fixation device;

4 is a radiograph of the pelvis of the animal after treatment.

The method is as follows.

In the operating room, after anesthesia and treatment of the surgical field, osteosynthesis of the affected joint is performed using an external fixation device. When it is performed by known methods, the fixing elements - knitting needles and / or screw rods - are transplanted (or cantilevered) at several levels into adjacent adjacent bone segments adjacent to the affected joint. The free ends of the clamps are mounted on the supports of the apparatus that are installed at the appropriate level, which are connected with each other with the help of threaded rods and hinged nodes with the possibility of dosed multi-plane movement and rotation.

If necessary, by displacing the supports of the apparatus and, accordingly, the fixed segments of the limbs or their fragments, the anatomically correct relationships of the joint components are restored. These manipulations can be performed both simultaneously, directly during the operation, and dosed in the postoperative period. The rate of dosed movement varies between 0.5-1 mm, dosed reversal - up to 5 ° per day.

After the restoration of the anatomically correct relationship of the affected joint, its articular surfaces are bred by an amount no more than half the normal width of the joint space. In this case, the criterion is to choose the width of the paired healthy joint or focus on the average dimensions of the joint gap of healthy animals of a similar breed, gender and age.

Following this, a catheter is inserted into the joint cavity expanded in this way, orienting and immersing its working end to the site with the most pronounced pathological changes. To visualize the process of installing a catheter, it is advisable to use a mandrin made of X-ray contrast material in it. The free end of the catheter is fixed on one of the supports of the apparatus adjacent to the joint zone.

In the presence of pathological contents in the articular cavity (blood, exudate, transudate, gases, etc.), it is partially or completely evacuated by attaching a suction mechanism to the catheter (syringe, vacuum pump, etc.). The selected contents of the cavity are analyzed and, based on the results obtained, as well as the orthopedic state of the joint, it is pre-washed or the medications are immediately injected or injected into the joint cavity. The introduction of drugs is carried out both in the course of one course, and prolongedly, over several courses of drug therapy. In the latter case, at the end of one course, the catheter is left in the joint cavity, ensuring its tightness. At the end of the drug therapy courses, the catheter is removed under sterile conditions and the width of the joint gap is normalized by the approach of the apparatus supports.

In the future, a stable fixation of the joint is carried out until the integrity of its components is restored. At the same time, active-passive movements with a gradually increasing amplitude can be developed in it. At the end of treatment, the apparatus is dismantled.

The practical implementation of the method is illustrated by the following observation.

Dog, male, age 1 year. Diagnosis: transverse fracture of the articular cavity of the left hip joint (figure 1).

To restore the integrity and function of the joint, the animal underwent surgery: closed osteosynthesis by the external fixation device of the pelvic and femoral bones on the left.

When performing osteosynthesis, three fixing knitting needles were transdermally passed through the wings of both iliac bones, as well as through the body and spinous process of the seventh lumbar vertebra, three knitting needles through the distal part of the femur and two knitting needles were cantilevered into the body and plate of the left sciatic bone.

The free ends of the spokes were fixed on three arc supports, which were connected with each other with the help of threaded rods and hinged nodes with the possibility of dosed multi-plane movement and rotation.

Displacement of the apparatus supports made a simultaneous reposition of fragments of the left articular cavity and centering of the femoral head. After that, the articular surfaces were bred by up to 50% more than the width of the joint space of the right hip joint.

Then a catheter was inserted into the articular cavity, bringing its working end to the fracture zone of the articular cavity. When a catheter was inserted, the presence of blood was revealed, which was pumped out, and the joint cavity was washed with a 0.9% sodium chloride solution. The operation was completed by performing control x-ray and stabilization of the apparatus systems (figure 2).

Starting from the seventh day after the operation, 1 ml of the drug Alflutop in a course of 5 injections with an interval between injections of 3-4 days was slowly injected into the joint cavity through the catheter previously installed. After the course of injections, the catheter was removed and the approach of the apparatus supports widened the width of the joint gap of the left hip joint normalized (Fig. 3).

Subsequently, the joint was fixed for 15 days by the apparatus with the simultaneous development of active-passive movements in it. The total duration of hardware fixation was 42 days.

As a result of treatment, the integrity of the articular cavity and the anatomically correct relationship of the left hip joint were restored. The animal walks, fully loading the operated limb, not limping. At the control examination after one year, the achieved treatment result is preserved, there are no signs of arthrosis (Fig. 4).

Using the method in the animal clinic of the RRC "WTO" named after Acad. G.A. Ilizarova showed that its use provides the possibility of treating the pathology of the joints, combined with a violation of the integrity and anatomically correct relationships of their components, as well as the prevention of injury to the tissues of the joints in the process of performing surgical procedures.

Claims (2)

1. A method of treating joint pathology in animals, including the installation of a catheter, the evacuation of the contents of the joint cavity and the introduction of drugs into it, characterized in that the joint is immobilized using an external fixation apparatus, the anatomically correct relationships of the components of the joint are restored, and then the joint surfaces are diluted by an amount , not more than half the normal width of the joint space, insert a catheter, bring its working end to the site of the joint with the most pronounced pa by biological changes, and medications are administered through the catheter, and then, after its removal, the width of the joint space is normalized and the joint is fixed until the integrity of its components is restored. 2. The method according to claim 1, characterized in that after conducting courses of symptomatic drug therapy, the joint is fixed with the possibility of developing active-passive movements in it.

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