RU2803958C1 - Aspiration-compression method of treating elbow bursitis - Google Patents

Abstract

FIELD: medicine; traumatology; orthopedics.

SUBSTANCE: invention can be used for aspiration-compression method of surgical treatment of elbow bursitis. Under local anesthesia, a puncture of the inflamed elbow joint bursa is performed using a device for regulating the direction of infusion flows Discofix S. Exudate is aspirated through the first channel of the device until the walls of the elbow joint bursa collapse. The channel of the device is closed to regulate the direction of infusion flows by turning the valve 90°. Negative pressure is created by pulling the plunger of a 10 ml syringe from the 0 to 3 ml mark, followed by closing the channel by turning the valve to 90°. Then a syringe with a 1.0 ml diprospan solution is connected to the second channel of the device for regulating the direction of infusion flows, the valve of the device for regulating the direction of infusion flows is opened and the diprospan solution is injected into the bursa cavity. An aseptic pressure bandage is applied to the soft tissues of the elbow joint area with a self-adhesive “Pecho-chaft” bandage.

EFFECT: method reduces the risk of disease relapse through aspiration and compression.

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Description

The invention relates to medicine, namely to traumatology and orthopedics, and can be used for surgical treatment of elbow bursitis.

Serous bursitis of the elbow joint accounts for at least 10 cases per 100 thousand population and can be complicated by purulent bursitis with the development of phlegmon, purulent arthritis and osteomyelitis (Akhtyamova N.E., 2016). Many methods have been proposed for the treatment of inflammation of the bursa of the elbow joint (Charyshkin A.L., Melky D.A., Glushchenko L.V., 2013; Kotyagina S.E., 2014). They consist of administering anti-inflammatory and sclerosing drugs into the bursa of the elbow joint (Chernov A.S., Petrova V.S., Shilova L.N., 2019). There are some other treatment methods in the form of applications and compresses to the elbow joint area. To date, the proposed methods have not led to a solution to the problem.

The invention is based on the task of creating an aspiration-compression method for the treatment of elbow bursitis, in which a significant improvement in the treatment result is achieved through aspiration and compression.

The solution to this problem is ensured by the fact that in the aspiration-compression method of treating elbow bursitis, a puncture of the inflamed bursa of the elbow joint is performed under local anesthesia using a device for regulating the direction of infusion flows Diskofix S from Bayer, aspiration of exudate through the first channel of the device until the walls of the ulnar bursa collapse joint, replacing with a new sterile syringe, creating negative pressure with a new syringe by pulling the piston of a 10 ml syringe from the 0 point to the 3 ml mark, followed by closing the channel by turning the valve 90°, introducing a solution of diprospan 1.0 into the bursa cavity through the second channel of the device, applying an aseptic pressure bandage to the soft tissues of the elbow joint with a self-adhesive “Pecho-chaft” bandage.

By pulling the plunger of a 10 ml syringe from the 0 point to the 3 ml mark, it was possible to create the negative pressure in the cavity of the ulnar bursa that was as safe as possible for tissues. It was not possible to create more negative pressure physically.

The invention is illustrated by Fig. 1, which shows the device Discofix C (Discofix C) from Bayer, Fig. 2, which shows the aspiration of the inflamed bursa of the elbow joint of the contents until the walls of the bag collapse, Fig. 3, which shows the procedure for administering the drug "Diprospan".

Our proposed method for treating elbow bursitis consists of performing a puncture of the inflamed bursa of the elbow joint under local anesthesia using a device for regulating the direction of infusion flows Discofix C (Discofix C) from Bayer, RU No. FSZ 2007/00003 dated 06/02/2020 (Fig. 1) , aspiration of its contents until the walls of the bag collapse (Fig. 2).

Having reached the collapse of the wall of the bag to the olecranon, the channel of the device was blocked to regulate the direction of infusion flows by turning the valve 90°. The used syringe with exudate was disconnected. Then, in its place, a new sterile syringe with a capacity of 10 ml was attached to the device for regulating the direction of infusion flows and the valve of the device for regulating the direction of infusion flows was opened by 90°. Next, negative pressure was created by pulling the piston of a 10 ml syringe from the 0 point to the 3 ml mark, followed by closing the channel of the device by turning the valve 90°. After this, a syringe (volume 2 ml) with a 1.0 ml solution of diprospan was connected to the second channel of the device for regulating the direction of infusion flows, the valve of the device for regulating the direction of infusion flows was opened and a solution of diprospan was injected into the bursa cavity (see Fig. 3). Then, the above-described system was removed from the cavity of the bursa of the elbow joint and the puncture site was simultaneously pressed with a sterile napkin. An aseptic pressure bandage was applied to the soft tissues of the elbow joint with a self-adhesive “Pecho-chaft” bandage. After the manipulation, restorative treatment is prescribed in the form of physical therapy for the fingers and physiotherapeutic treatment.

The method leads to a reduction in disease relapse. 36 patients were treated using the above method, who were then observed for 2 years (from 2020 to 2022). Relapse of the disease was noted in 3 patients (8.3%). The use of the method reduces the period of temporary disability, relapse of the disease and material costs for the treatment of patients with elbow bursitis. The technical solution to our rationalization proposal is aspiration of exudate with simultaneous administration of a glucocorticosteroid drug.

Patient S., 43 years old, complained of the presence of a soft tissue formation on the posterior surface of the right elbow joint, which arose 4 days ago. Upon presentation, based on clinical and instrumental data, a diagnosis was made: elbow bursitis on the right. The patient was treated conservatively using the proposed method. Under local anesthesia with a 0.5% lidocaine solution, a puncture of the inflamed elbow joint bursa was performed using a device for regulating the direction of infusion flows Discofix C (Discofix C) from Bayer, RU No. FSZ 2007/00003 dated 02.06.2020. Aspiration of serous exudate in a volume of 20 ml until the walls of the elbow joint bursa collapse and creating a negative pressure of up to 3 ml with a 10 ml syringe. With subsequent blocking of the channel by turning the valve 90° and introducing a solution of Diprospan 1.0 into the cavity of the bursa. A pressure aseptic bandage was applied to the soft tissues in the area of the elbow joint using a self-adhesive Pecho-chaft bandage.

After the manipulation is completed, restorative treatment is prescribed in the form of physical therapy for the fingers and physiotherapeutic treatment.

36 patients were performed using the above method, who were then observed for 2 years (from 2020 to 2022). Relapse of the disease was noted in 3 patients (8.3%).

Patient K., 47 years old, complained of the presence of a soft tissue formation on the posterior surface of the right elbow joint, which arose 4 days ago. Upon presentation, based on clinical and instrumental data, a diagnosis was made: elbow bursitis on the right. The patient was treated conservatively using the proposed method. Under local anesthesia with a 0.5% lidocaine solution, a puncture of the inflamed elbow joint bursa was performed using a device for regulating the direction of infusion flows Discofix C (Discofix C) from Bayer, RU No. FSZ 2007/00003 dated 02.06.2020. Aspiration of serous exudate in a volume of 15 ml until the walls of the elbow joint bursa collapse and creating a negative pressure of up to 2 ml with a 10 ml syringe. With subsequent blocking of the channel by turning the valve 90° and introducing a solution of Diprospan 1.0 into the cavity of the bursa. A pressure aseptic bandage was applied to the soft tissues in the area of the elbow joint using a self-adhesive Pecho-chaft bandage.

This patient was examined after 3 months, 6 months and 1 year. After 1 year, symptoms of relapse of the disease are noted in the form of swelling of soft tissues in the projection of the olecranon, discomfort in the elbow joint when flexing the forearm

BIBLIOGRAPHY

1. Akhtyamova N.E. Modern approaches to the treatment of bursitis (recommendations for an outpatient surgeon). RMJ. Medical Review. 2016; 24(3):193-196.

2. Charyshkin A.L., Melky D.A., Glushchenko L.V. Minimally invasive treatment of serous bursitis of the elbow joint //Ulyanovsk Medical and Biological Journal. - 2013. - No. 3.

3. Chernov A. S., Petrova V. S., Shilova L. N. Features of the course and treatment of gout in the modern world // Medicinal Bulletin. - 2019. - T. 13. - No. 4. - pp. 22-27.

4. Akhtyamova N. E. Modern approaches to the treatment of bursitis (recommendations for an outpatient surgeon) // Russian Medical Journal. Medical Review. - 2016. - T. 24. - No. 3. - pp. 193-196.

5. Kotyagina S.E. MRI in assessing the activity and determining the phase of chronic osteomyelitis //Modern problems of science and education. - 2014. - No. 3. - pp. 456-456.

Claims (1)

An aspiration-compression method for the treatment of elbow bursitis, characterized by the fact that, under local anesthesia, a puncture of the inflamed bursa of the elbow joint is performed using a device for regulating the direction of infusion flows Discofix C, the exudate is aspirated through the first channel of the device until the walls of the bursa of the elbow joint collapse, the channel of the device is blocked for to regulate the direction of infusion flows by turning the valve 90°, create negative pressure by pulling the piston of a 10 ml syringe from the 0 to 3 ml mark, followed by closing the channel by turning the valve 90°, then connect a syringe with a solution to the second channel of the device for regulating the direction of infusion flows diprospan 1.0 ml, open the valve of the device to regulate the direction of infusion flows and inject diprospan solution into the bursa cavity, apply an aseptic pressure bandage to the soft tissues of the elbow joint with a self-adhesive Pecho-chaft bandage.