RU2417747C1 - Method for hemarthrosis and gonarthritis measurement - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology and orthopaedics. A shin is extended 180 degrees. A bar of the device is placed on an anterior surface of the shin. Then the second bar of the device is descended on the anterior surface of a knee joint, and a distance between the anterior surface of the shin and the anterior surface of the knee joint is evaluated.

EFFECT: development of a reliable and objective method for gonarthritis and hemarthrosis measurement in dynamics: before the beginning of treatment, during treatment and after the end of the therapeutic course.

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Description

The invention relates to medicine, namely to traumatology and orthopedics.

Analogue: There is a method of measuring the diameter of the medullary canal and the length of the tubular bone in order to select an optimal size retainer for intramedullary osteosynthesis (Boykov V.P. Calibration plate-ruler / V.P. Boykov // Orthopedics, traumatology and prosthetics. - 1983. - No. 1. - P.65-66. Measurement procedure: The test limb is placed on an X-ray cassette (if the test segment exceeds the length of the cassette, 2 cassettes can be used simultaneously.) A calibration ruler is installed on the cassette next to the limb. By expanding the nuts on the rods, the calibration plate is installed at the same level with the middle of the bone. Telescopic rulers are pushed in opposite directions and X-ray diffraction is made. On the roentgenogram, the links of the rulers and holes in the plate are clearly visible. Knowing the link length and the length of the plate, you can determine, from the picture, the bone length On the roentgenogram, the hole of the calibration plate corresponding to the “radiographic” (projection distorted) width of the medullary canal is selected, and thus the true size k stnomozgovogo channel.

Criticism of analogues:

- To perform the study, you must perform an x-ray of the segment. The authors did not indicate which focal length they chose and how they took into account the distortions that were inevitable during the X-ray examination.

Prototype:

As a prototype method, a method for determining a modified dynamic indicator of edema according to E.F. Uratkov (Dubrovin G.M. System of complex treatment and rehabilitation of patients with deforming osteoarthritis of the knee joints: author. Diss. ... doctor of medical sciences / Dubrovin Grigory Mendelevich; GOU VPO “Kursk State Medical University of Roszdrav.” - Kursk, 2003. - 40.). The dynamic indicator of edema was calculated by the formula: DPO = ((Cx-Co): Co) × 100%, where Cx is the sum of measurements of three indicators of the circumference of the sore joint (at the level of the patellar ligament, middle of the patella, upper inversion), Co - Sum of measurements three indicators of the circumference of a healthy joint. A comparison of several dynamic indicators during the treatment process characterizes its effectiveness.

The disadvantages of the prototype method are:

- It is necessary to measure both the affected and healthy joints. However, with arthrosis, both joints are more often involved in the process, therefore, none of them can be considered healthy. The reliability of such a measurement is doubtful.

- The method provides for measurements at several levels, without specifically indicating the points on which to apply the measuring tape.

- The upper inversion when filling the joint increases in volume. Since the severity of the pathological process in both joints can be different, then the visually defined boundaries of the upper inversion will differ. Therefore, it is not possible to measure the circumference in a symmetrical section of the upper inversion of both knee joints.

- The study takes a lot of time, since it involves measurements on symmetrical sections and the implementation of stage calculations.

The invention:

Proposed as an invention, the method is depicted in figure 1 and figure 2, where

- drumstick (figure 1, position 1; figure 2, position 1);

- knee joint (figure 1, position 2; figure 2, position 2);

- thigh (figure 1, position 3; figure 2, position 3);

- strap (figure 1, position 4; figure 2, position 4);

- a device for diagnosis and dynamic control of hemarthrosis and synovitis of the knee joint (figure 1, position 5; figure 2, position 5);

- the front surface of the lower leg (figure 1, position 6; figure 2, position 6);

- a sliding bar (Fig. 1, pos. 7; Fig. 2, pos. 7);

- the front surface of the knee joint (figure 1, position 8; figure 2, position 8);

- scale (figure 1, position 9; figure 2, position 9).

The aim of the invention is the quantitative control of hemarthrosis and synovitis of the knee joint in dynamics.

This goal is achieved using the “Device for the diagnosis of hemarthrosis and synovitis of the knee joint” (Positive decision to grant a patent for a utility model according to application No. 2009107529/22 (010054) dated 02.03.2009). The proposed method is as follows: the lower leg (figure 1, position 1; figure 2, position 1) is extended in the knee joint (figure 1, position 2; figure 2, position 2) to 180 ° to the hip (figure 1, position 3; figure 2, position 3). The bar (figure 1, position 4; figure 2, position 4) of the device for diagnosis and dynamic control for hemarthrosis and synovitis of the knee joint (figure 1, position 5; figure 2, position 5) is installed on the front the surface of the leg (figure 1, position 6; figure 2, position 6). Then lower the sliding bar (Fig. 1, pos. 7; Fig. 2, pos. 7) on the front surface of the knee joint (Fig. 1, pos. 8; Fig. 2, pos. 8) and evaluate the distance between the front surface of the lower leg (figure 1, position 6; figure 2, position 6) and the front surface of the knee joint (figure 1, position 8; figure 2, position 8), characterizing the severity of synovitis or hemarthrosis, on a scale (figure .1, pos. 9; Fig. 2, pos. 9).

An example of a specific implementation: Patient M. (62 years old) went to the Healthy Family Clinic on 07.14.09 with complaints of pain in the area of both knee joints, swelling and limitation of movement in the joints. After collecting an anamnesis, a standard study of local status, detecting fluctuations in the projection of the superior inversion and ballot of the patella, the synovitis of the right and left knee joints was measured. The study was performed in the extension of the lower leg, up to 180 °, in the knee joint. The bar of the device for diagnosis and dynamic control for hemarthrosis and synovitis of the knee joint was installed on the front surface of the lower leg. Then the sliding bar was lowered onto the front surface of the knee joint (the most protruding part) and the distance between the front surface of the lower leg and the front surface of the knee joint was estimated on a scale. On the right, a value of 24 mm was obtained, on the left, 26 mm. After X-ray and ultrasound studies, the diagnosis was made: Deforming arthrosis of both knee joints II-III art. Prescribed treatment. After three weeks, the studies were repeated and the values were obtained: on the right - 18 mm, on the left - 19 mm, which, along with an anamnesis and local status data, indicated an upcoming improvement against the background of the therapy.

Distinctive features of the invention:

From the known methods for measuring hemarthrosis and synovitis of the knee joint, this method differs in that

- Allows you to examine both joints and one joint, in contrast to the prototype method. In this case, it is enough to compare the results of measurements of the same joint obtained at different stages of treatment.

- The measurement surface is the anterior surface of the knee joint (the most protruding part) and the anterior surface of the lower leg. Moreover, the search for certain points is not required, as in the prototype method.

- The study takes less than 1 minute and does not require complex calculations.

The technical result of the invention is an affordable, reliable and objective way to measure synovitis and hemarthrosis of the knee joint in dynamics: before treatment, during treatment and after completion of the course of treatment.

Information sources

Boykov V.P. Gauge plate-ruler / V.P. Boykov // Orthopedics, traumatology and prosthetics. - 1983. - No. 1. - S. 65-66.

Dubrovin G.M. The system of complex treatment and rehabilitation of patients with deforming osteoarthrosis of the knee joints: author. dis ... doctor honey. Sciences / Dubrovin Grigory Mendelevich; GOU VPO "Kursk state. honey. University of Roszdrav. " - Kursk, 2003. - 40 - prototype.

Claims (1)

A dynamic control method for hemarthrosis or synovitis of the knee joint, including extension of the lower leg to 180 ° and installation of the 1st level on the front surface of the lower leg, the 2nd level is installed on the most protruding part of the surface of the knee joint, while the dynamic control is carried out by the difference in the distance between the levels .

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