SU1031438A1 - Method of implanting vessel fascicle in wrist bone - Google Patents

Description

The invention relates to medicine, namely to traumatology and orthopedics for the treatment of aseptic necrosis of the semi-lunar bone in the initial stage, non-adjacent fractures, false joints and aseptic necrosis. scaphoid in the initial stage. There is a known method of implanting a vascular bundle into the populunus and boat bones, which consists in attaching the bone autotransplant to the distal end of the vascular bundle with a thin thread and in the subsequent implantation of the vascular bundle into the shaped canal in the lunar or roach bone. This ensures the fixation of the bundle by jamming the bone graft in the depth of the canal, revascularization of the bones, which speeds up the process of their regeneration. The disadvantage of this method is to apply additional herbs to the bone autotransplant, significant injury of the vascular bundle with bone implantation into the bone , the long duration of the operation is insufficient. stability of fixation of the vascular bundle, which, in turn, can result in it coming out of the canal channel during pulsation. The purpose of the invention is to provide a stable fixation of the beam in the bone canal, atraumatic shortened operation time. The goal is achieved by the method of implanting the vascular bundle into the bone of the bone by introducing the vascular bundle into the bone canal to form a through oblique canal with a transition from larger to smaller diameter of the holes, introducing the catgut filament and conductor into the canal beyond the distal end. through a hole of a larger diameter, then the catgut thread is pulled out through the hole of a channel of smaller diameter and fixed through the skin on a gauze roller. The method is carried out as follows. The vascular bundle is isolated under an operating microscope and using appropriate instrumentation. The second posterior fusion artery and vein with the perivascular tissues surrounding them are used as the vascular bundle. At the place of dividing the beam into the back of one's own digital vessels, it is reversed and cut off. In the proximal direction, the vascular bundle is elevated to the level of the apoplastic joints. In the bone into which the vascular bundle is implanted, a channel with a diameter of 3.3 mm is drilled in the longitudinal direction. The channel in the scaphoid bone with non-adult fractures and false joints should pass through the plane of the fracture from the distal to the proximal mentality. After that, a special conductor, made of Kirschner needles with a diameter of 1.2 mm and having an eyelet with a diameter of 0.5 mm at the end, is clamped into the drill chuck and guided through the channel into the bone until it exits from the opposite side. The catgut filament is threaded into the ear of the conductor and is pulled from the opposite side, with the thread passing through the formed channel into the bone. The distal end of the filament is attached to the distal end of the vascular bundle. The thread is pulled out, the vascular bundle is implanted atraumatically into the bone canal, then careful hemostasis is performed, the pulsation of the vascular bundle is checked and the wound is sutured in layers. The beam is fixed by the same thread, the end of which is stitched in a tensioned state through the skin on a gauze roller to the region of its exit from the tissues. By the time the catgut's bath was resorbed, the bundle is stably fixed to the bone due to the proliferation of capillaries. After the operation, a deep plaster cast is applied from the petno-fangoanal joints to the elbow. For example. Patient K., 19 years old, was admitted to the CITO about the unsteady fracture of the scaphoid bone of the left hand with complaints of pain in the left wrist joint, which increased sharply during physical exertion and movements, limited movement and reduced hand strength. He received a joint injury 10 months ago in a fall. On palpation in the projection of the navicular bone, pain was determined. Active and passive movements in the wrist joint are limited and painful (flexion 600, extension. The strength of the right hand is 75 kg, and the left 30 kg.

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Claims (1)

METHOD FOR IMPLANTING A VASCULAR BEAM IN THE WRIST BONE by introducing a vascular bundle into the bone canal, which is based on the fact that, in order to ensure stable fixation of the bundle in the bone canal, atraumaticity and reduction of the duration of the operation, a through bone canal is formed with a transition from a larger to a smaller diameter of the holes, a vascular bundle is introduced into the channel beyond the distal end using a catgut thread and a conductor through a hole of a larger diameter, then the catgut thread is brought out through the opening of a channel of a smaller diameter and fix tear through the skin on a gauze roller. 8 £ S 190 1 1031438 *