RU2446762C1 - Method of eliminating patella dislocation in children - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to traumatology and orthopedics. Carried out is longitudinal dissection of own patella ligament from lower patella pole to tuberosity of tibia in sagittal plane into two parts: external and internal. External part of own patella ligament is passed through created cut of internal part of own patella ligament in frontal plane. Transferred part of own patella ligament is fixed transosseously by means of interrupted sutures inward from tuberosity of tibia.

EFFECT: method provides possibility of early knee joint training with further possibility of independent travel, reduction of recurrence of patella dislocation outwards.

3 dwg

Description

The invention relates to medicine, namely to orthopedics.

There is a method of eliminating patellar dislocation in children (operation Ru), which consists in cutting off the tibial tuberosity with its own ligament of the patella with subsequent fixation of its inside 2-2.5 cm in order to eliminate the external dislocation of the patella (Volkov M.V. Multivolume guide to traumatology and orthopedics T.2, S.770, 1968).

There is also a method of eliminating the dislocation of the patella outward, which consists in medializing the internal portion (part) of the patellar ligament, in which the tibial tuberosity is not cut off (Volkov M.V. Multivolume guide to traumatology and orthopedics. T.2, P.772, 1968 ) The movement inside the patella is achieved in this case by medializing the internal portion (part) of the patellar ligament.

However, in the first method, when cutting off the tibial tuberosity, damage to its growth zone in children of preschool and school ages leads to the formation of recurrent deformity of the lower leg. The prompt elimination of patellar dislocation by medializing the internal portion (part) of the patellar ligament described in the second method does not provide reliable retention of the patella in the anatomically correct position.

As a result, both methods cannot be applied in children of younger and preschool age due to the possibility of relapse and the need for repeated surgical interventions.

The objective of the invention is to increase the effectiveness of surgical treatment of children under 13 years of age by eliminating the intersection of the tibial apophysis, excluding the movement of the inner part of the patellar ligament inside the knee, which allows to obtain a stable clinical effect, significantly reduce the recurrence of patellar dislocation outward.

The technical result of the task is achieved by the fact that in the method of eliminating the dislocation of the patella in children, including longitudinal dissection from the lower pole of the patella to the tuberosity of the tibia in the sagittal plane of the own ligament of the patella in two parts: the external and internal, and transossal fixation of the moved part of its own ligament of the patella nodular sutures inward from the tibial tuberosity, it is proposed that the outer part of the patellar ligament be carried through the created pro Take the inside of your own patellar ligament in the frontal plane.

Figure 1, 2 presents a diagram of a method for eliminating dislocation of the patella in children.

Pos. 1 - patella; Pos. 2 - tibia; Pos. 3 - the outer part of the patellar ligament; Pos. 4 - inner part of the patellar ligament; Pos. 5 - a cut in the inner part of the patellar ligament.

Figure 3 presents a diagram of the result of the operation.

Pos. 1 - patella; Pos. 2 - tibia; Pos. 3 - the outer part of the patellar ligament; Pos.4 - the inner part of the own ligament of the patella.

The method is as follows.

In the area of the knee joint and the upper third of the tibia, an incision is made in the skin and subcutaneous fatty tissue up to 6-8 cm long in the projection of the patellar ligament 1 from its apex to the proximal tibia metaphysis 2.

A scalpel in the sagittal plane dissects its own ligament of the patella 1 in half with cutting off the outer part 3 of it from the tuberosity of the tibia 2 (Fig. 1). Through the created slot 5 in the inner part 4 of the own ligament of the patella 1 in the frontal plane on the ligatures, the outer part 3 of the own ligament of the patella 1 (Fig. 2) is passed and is fixed medial to the tuberosity of the tibia 2 by one centimeter with transosseous interrupted sutures (Fig. 3).

The method can be applied in children under 13 years of age in order to eliminate pathological dislocation of the patella of the II degree outside, as well as after corrective osteotomy for valgus or valgus-torsion deformity of the femur.

The positive effect of the invention is: obtaining a persistent clinical effect; early development of the knee joint with the subsequent possibility of independent movement; a significant reduction in the occurrence of relapse.

Claims (1)

A method for eliminating the dislocation of the patella in children, including longitudinal dissection from the lower pole of the patella to the tuberosity of the tibia in the sagittal plane of the patellar ligament into two parts: the external and internal, and transossal fixation of the movable part of the patellar ligament with interrupted sutures, from the tibial tuberosity that the outer part of the patellar ligament is carried out through the created slot in the inner part of the patellar ligament rontalnoy plane.

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