RU2436525C1 - Sewing method of treating serous olecranon bursitis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to surgery, traumatology, and is intended for treatment of serous olecranon bursitis. Method includes aspiration of synovial bursa content. After paracentesis with 1 cm step sewing under synovial bursa by subcutaneous kapron sutures is carried out. The latter are tied up above gauze roll. Removal of sutures after 14 days contributes to reduction of treatment terms, as well as does not exclude possibility of easy work during said period.

EFFECT: application of claimed invention makes it possible to exclude further surgery.

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Description

The invention relates to surgery, traumatology and is intended for the treatment of serous ulnar bursitis.

A known method of treating ulnar bursitis by removing the affected synovial bag [Lamm Y.E. Traumatic occupational bursitis. - M., 1966], leading to a violation of the conditions of interaction between joints, tendons and muscles, increased pressure and friction of muscles and tendons during movement and the formation of a dissected bag in place of a new one with the subsequent development of the pathological process characteristic of chronic bursitis in it. In addition, during surgery, incomplete removal of the affected synovial bag, insufficient subsidence of the resulting wound cavity and the formation of a hematoma at the site of the excised bag are possible, which leads to relapse.

It is known that the closest method of the same purpose to the claimed invention according to the totality of features is a method of treating affected synovial bags by regular aspiration procedures [Reznik S.D. Chronic traumatic bursitis of the knee and elbow joints. - Kiev, 1962] and drainage [Shulgina E.I. Pat. RF No. 99127874, 2001] the contents of the synovial bags, flushing their cavities with the drug and introducing the drug into the cavity of the synovial bags.

Along with the advantage of methods such as the ability to save a synovial bag, it has disadvantages that significantly degrade its quality. These treatment methods do not provide for the removal of tissue breakdown products and cell waste products. Thus, the above method of treatment [Reznik S.D. Chronic traumatic bursitis of the knee and elbow joints. - Kiev, 1962] is ineffective against inflammatory processes caused by tissue breakdown products and cell waste products, which in many cases is accompanied by a violent suppurative cell process and worsens the patient's condition.

Treatment of serous ulnar bursitis is possible when performing surgery by paired para-lekronalny incisions [Pautkin Yu.F. and other outpatient surgery. - M.: Publishing House of the Peoples' Friendship University of Russia, 2000, p.190-191]. The advantage of this method is the preservation of the synovial bag, but at the same time, the invasive method of treatment increases the possibility of microorganisms entering, the development of suppurative process and subsequent relapses. The disadvantage of this method is the long incapacity for work of the patient.

To eliminate these disadvantages of the proposed invention.

The objective of the proposed method for the treatment of the synovial bag of the elbow joint is to prevent inflammatory processes caused by tissue breakdown products and cell waste products, prevent the appearance of coarse scar tissue, eliminate the possibility of injury to the walls of the bag, reduce the likelihood of additional surgery and remove synovial bags, as well as shorten the treatment time for patients .

The problem is solved by puncturing the contents of the ulnar synovial bag and removing exudate, which favorably affects the development of inflammation. To increase pressure on the synovial bag, to prevent the accumulation of serous fluid, the appearance of scar tissue and to eliminate the possibility of injury to the walls, the projection perimeter is sutured with skin nylon seams under the synovial bag in 1 cm increments. The method is minimally invasive and does not require further surgical intervention. Removing sutures after 14 days helps to reduce treatment time, and also does not exclude the possibility of light labor during this period.

A firmware method for treating ulnar bursitis consists of the following steps.

1. Local anesthesia with a 0.5% solution of novocaine or 1% lidocaine over the entire area of the skin above the elbow bag 1 (see drawing), using the method of crawling infiltrate.

2. Use a thick needle to puncture the elbow bag and remove the exudative fluid.

3. Subcutaneously carry out nylon seams 3 (see drawing) under the synovial bag, in increments of 1 cm.

4. Apply a gauze roller over the projection of the bursa.

5. The sutures are tied over the gauze roller 2 (see drawing) in order to prevent the eruption of skin sutures and increase pressure on the bursa.

6. After 14 days, the sutures are removed.

7. In the postoperative period, analgesics and dressings are prescribed (every 3 days), antibiotic therapy is not prescribed.

From 1998 to 2009, at the base of Clinic No. 1 named after S.M. Kirov, Ulyanovsk, 56 patients with acute ulnar bursitis were treated. Men amounted to 42, women - 14 people. The average age of patients is 36 years. Prior to applying the method, all patients underwent puncture treatment for 4 weeks, which was ineffective. For all 56 patients, the developed method for the treatment of acute bursitis was applied.

After 14 days, in all 56 cases, positive results were obtained, which consisted in eliminating the signs of serous ulnar bursitis.

The average duration of outpatient treatment for the proposed method was 14 days. It should be noted that when applying this method, the ability to work decreased slightly, and 42 patients continued to work. There were no purulent complications. There was a reddening of the skin and slight infiltration at the site of suturing, which took place after suturing.

To assess long-term results, 36 out of 56 patients were examined. In the group of 36 patients, during control examinations after a year, no recurrence of serous bursitis of the elbow joint was found.

The claimed method for the treatment of affected synovial bags is economical and, along with the absence of an irritating effect when the drug is administered to the affected area, increased pressure on the bag, removal of tissue decay products and cell waste products, accelerates the regeneration of damaged cells, increases efficiency in preventing inflammatory processes caused by decay products tissues and vital products of cells, prevents the appearance of coarse scar tissue, the possibility of tr vmirovaniya walls bursa, synovial preclude removal bags, reduces the treatment of patients.

Literature

1. Lamm Y.E. Traumatic occupational bursitis. - M., 1966.

2. Reznik S. D. Chronic traumatic bursitis of the knee and elbow joints. - Kiev, 1962.

3. K.M.Sherepko. Application for invention No. 99127874/14, 12.30.1999

4. Pautkin Yu.F. and other outpatient surgery. - M.: Publishing House of the Peoples' Friendship University of Russia, 2000, p.190-191.

Claims (1)

A method of treating bursitis using aspiration of the contents of the synovial bag, characterized in that after a puncture in 1 cm increments, flashing under the synovial bag is carried out with hypodermic nylon seams that are tied over a gauze roller.

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