RU2407474C1 - Method of treating congenital diastasis (splitting) of knee joint in children - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics. In area of proximal metaphyses of tibia and fibula formed are two canals in frontal plane at distance 1.5 cm from each other. Through canals allotendon is passed in order to create tie. In area of distal hip epimetaphysis and both proximal epimetaphyses of shin bones two canals are formed, into which allotendon is passed in order to create lateral and crucial ligaments. Fixation of lower extremity is performed by means of plaster cast in position of flexion at angle 150.

EFFECT: method ensures knee joint stabilisation, eliminating expressed lateral and anterior-posterior looseness of joint, possibility of loading on extremity without application of external fixation, preservation of satisfactory volume of movements in knee joint.

2 dwg

Description

The invention relates to medicine, namely to orthopedics.

A known method of treating congenital diastasis of the knee joint with malformations of the proximal leg bones, including screed of the tibia and fibula bones with a split tendon of the biceps femoris muscle, carried out in the canal formed in the proximal metaphysis of the tibia and fibula (Mena B, Johns Brauti, Brauns. biceps femoris tendon reconstruction for proximal tibiofibular jont instability Arhtroscopy. 2001 Jul; 17 (6): 668-71. - prototype).

The disadvantage of this method of treatment is that it does not provide stability in the knee joint in the frontal and sagital planes, since with this method there is no strengthening of the cruciate and lateral ligaments.

The objective of the invention is to create a stable functional knee joint, eliminating the pronounced lateral and anteroposterior laxity, the ability to load a limb without external fixation with splint leather devices and other products, maintaining a satisfactory range of motion in the knee joint, allowing the patient to use without restrictions in everyday life limb.

The technical result of the task is achieved by the fact that in the method of treating a split knee joint, including a screed of the proximal end of the tibia and fibula, with a split tendon of the biceps femoris, carried out in the bone canal of the tibia and fibula, it is proposed that in the proximal metaphyses of the tibia and tibia two channels in the frontal plane at a distance of 1.5 cm from each other, through which to conduct an allotope to create a screed, in two channels are formed in the areas of the distal epimitaphysis of the femur and both proximal epimetaphyses of both lower leg bones, in which an allotendin is used to create lateral and cruciate ligaments, the lateral and cruciate ligaments are formed with moderate allotendin tension, so that at the level of the knee joint there is the possibility of bending at an angle of 90 ° and extension to 180 °, fixing the lower limb is carried out with a plaster cast in the bending position at an angle of 150 °.

Figure 1 and 2 presents the treatment regimen for congenital diastasis of the knee joint in children:

figure 1 Scheme of channel formation in the epimetaphysis of the thigh and epimetaphysis of the bones of the leg:

Pos.1 - conducting two channels to create a screed of the lower leg bones in the metaphyses of the tibia and fibula.

Pos.2 - channel for the formation of the anterior cruciate ligament in the distal femur epimetaphysis.

Pos.3 - channel for the formation of the posterior cruciate ligament in the distal femur epimetaphysis.

Figure 2 Scheme of conducting allotendinum for the formation of the anterior and posterior cruciate and lateral ligaments and create a screed of the lower leg bones by allotendinum:

Pos.4 - fixation (screed) by allotissue of the bones of the lower leg from their divergence in the frontal plane.

Pos. 5 - plastic of the internal lateral ligament of the knee joint,

pos.6 - plastic anterior cruciate ligament of the knee joint,

pos.7 - plastic of the posterior cruciate ligament of the knee joint,

pos.8 - plastic external lateral ligament of the knee joint,

The method is as follows.

From the external parapathelial incision made from the middle third of the thigh to the middle third of the leg, the cavity of the knee joint is opened, the tendon of the 4-head muscle of the thigh, the patella and the patellar ligament are highlighted. In the proximal metaphysis of the tibia and fibula, departing from the growth zone of 5 cm, two channels are formed in the frontal plane (Fig. 1, pos. 1), through which an allotissue is made to create a screed of both lower leg bones from their divergence in the frontal plane (Fig. 2 item 4). In the region of the distal epimetaphysis of the femur and both epimetaphyses of the lower leg bones, two channels are formed (Fig. 1, pos. 2, 3), through which an allograft is created to create cruciate and lateral ligaments simultaneously (Fig. 2, pos. 5, 6, 7, 8) . The formation of lateral and cruciate ligaments is carried out with moderate tension of the allograft, so that at the level of the knee joint there is the possibility of flexion to an angle of 90 ° and extension of 180 °, lateral mobility within 8-10 °. The limb is fixed with a circular plaster cast to the groin in the position of flexion in the knee joint at an angle of 150 °.

A positive effect of using the method of treating congenital diastasis of the knee joint in children is the creation of a stable knee joint, which excludes pronounced lateral and anteroposterior loosening, the ability to load a limb without external fixation with splint leather devices and other products, maintaining a satisfactory range of motion in the knee joint, allowing the patient to use his limb without restrictions in everyday life.

Claims (1)

A method for the treatment of congenital diastasis of the knee joint in children, including a screed of the proximal end of the tibia and fibula, with a split tendon of the biceps femoris, carried out in the bone canal of the tibia and fibula, characterized in that in the area of proximal metaphyses of the tibia and peroneal canal at a distance of 1.5 cm from each other, through which an allograft is made to create a screed, in the area of the distal epimetaphysis of the thigh and both Two channels are formed of the maximal epimetaphyses of the lower leg bones, in which an allotendin is used to create lateral and cruciate ligaments; the lower limb is fixed with a plaster cast in the bending position at an angle of 150 °.

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