RU2645642C1 - Transligent-patellar operative access to the knee joint of small cattle (sheep) - Google Patents

Abstract

FIELD: veterinary science.

SUBSTANCE: invention relates to the field of veterinary medicine and is intended for use in operative access to the knee joint of a sheep. Sheep in position on the side is fixed to the operating table. Lower third of the thigh and the upper third of the shin of the sheep's limb, on which the surgical procedure is performed, is cut, the assistant holds it in the bending position. Surgical access zone is treated with an antiseptic. Along its own patellar ligament, starting from its lower corner to the tuberosity of the tibia, an incision of the skin of 3 cm long is performed. Next step is the dissection of subtle subcutaneous fat, providing access to its own patellar ligament. Own patellar ligament is extended all over. Edges of the ligament are separated and fixed. Dissecting part of the fat body, creating a "floating window", with the displacement of which medial condyle is medially visible, and with lateral displacement is the lateral condyle.

EFFECT: method allows for safe operative access to the knee joint for visualization of both hip condyles.

1 cl, 4 dwg

Description

The invention relates to the field of veterinary medicine.

Various operative approaches to the knee joint of small cattle are known. One of the earliest approaches is medial access to the joint along the medial ligament from the cartilaginous process of the kneecap to the upper thickened end of the tibial crest. The incision is 6-8 cm above the direct medial ligament, having previously stretched the skin with the fingers of the left hand (Chubar V.K. Operative surgery of domestic animals. Textbook. Moscow, 1951. P.467).

The closest in technical essence is the medial parapatellar approach (Kupryakov A.P. Experimental models for the study of damage and repair of articular cartilage of synovial joints. The dissertation for the academic degree of candidate of medical sciences Moscow, 2009. P.50).

Technique of operation: through anteromedial access with a needle and a syringe, 10 ml of 0.5% Lidocaine (or Novocaine) is injected into the joint cavity to tension the joint capsule and thereby facilitate access to it. The skin and subcutaneous tissue are cut parallel to the medial surface of the patellar ligament, 1 cm away from it. The subcutaneous fatty tissue is diluted stupidly and fixed with the help of Farabef hooks to the wound edge as an assistant. In this location, large vessels do not pass, which is due to the absence of bleeding upon access. Reaching the medial support device of the patella, retreating 1 cm from the distal edge, the fibers of the medial ligament of the patella — lig, are longitudinally diluted for 2.5–3 cm. patellae mediale, under it the anteromedial part of the infrapatellar fat body is visualized. At this stage, access to the joint capsule must be done with extreme caution, as in this place pass the medial envelope of the arteries, forming a square, in the center of which it is necessary to pass, leaving the walls of the vessels intact.

This access is complicated in execution and allows you to visualize only the medial condyle of the thigh.

The task was set of safe operative access to the knee joint for visualization of both condyles of the thigh.

The task is achieved by performing anterior arthrotomy through its own ligament of the patella with the creation of a “floating window”, with displacement of which the medial condyle of the femur is medially determined, and the lateral condyle of the femur is medially determined.

The proposed technical solution is as follows.

The sheep in the lateral position is fixed to the operating table. The lower third of the thigh and the upper third of the leg of the leg of the sheep, on which the surgery is directly performed, is sheared, the assistant holds it in the bent position, thereby giving the opportunity to determine the anatomical landmarks: the tibial condyle, own patellar ligament and patella. The surgical access area is repeatedly treated with an antiseptic. A 3 cm long skin incision is made along the patellar ligament, starting from its lower corner to the tibial tuberosity. The next step is dissection of the mild subcutaneous fat, providing access to the patellar ligament. Own ligament of the patella is spread all over. The edges of the ligament are bred and fixed with Farabeff hooks. It is worth noting that the skin in this area is quite malleable and allows you to shift the edges of the wound up to 2 cm. For better visualization of the condyles of the thigh, a part of the fat body is excised, a “floating window” is created, with the medial condyle being medially visible, and with the lateral displacement, lateral condyle.

Photo 1 shows the planned planned incision, where 1 is the patella, 2 is the tibial tuberosity, 3 is the planned incision.

Photo 2 shows an arthrotomy, where 1 is the patella, 4 is the planned site for dissection of the patellar ligament.

Photo 3 shows the medial condyle of the thigh, where 5 is the medial condyle, 6 is the spaced patellar ligament of its own.

Photo 4 shows the lateral condyle of the thigh, where 7 is the lateral condyle of the thigh, 6 is the spaced patellar ligament of its own, and 8 is the defect performed.

Using the proposed transligamentopatellar access to the knee joint of small cattle allows visualization of both condyles of the thigh.

Claims (1)

Transligmento-operative operative access to the knee joint of a sheep, including an incision in the skin and subcutaneous adipose tissue, characterized in that the knee joint is held in a bent position and along the patellar ligament, starting from its lower angle to the tibial tuberosity, a skin incision of 3 cm is performed, dissection of the subcutaneous fat, the patellar ligament is spread apart throughout, the edges of the ligament are diluted and fixed with the possibility of displacement of the edges of the wound up to 2 cm, a part is excised Irova body, creating a "floating window" during which offset medially visualize the medial femoral condyle, while the displacement of the "floating window" laterally visualize the lateral femoral condyle.

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