SU1061805A1 - Method of surgical treatment of the consequencies of congential dislocation of the thigh - Google Patents

Abstract

METHOD FOR SURGICAL TREATMENT EFFECTS congenital hip By subtrochanteric osteotomy of the femur and forming its dugoobr heat deformation arc open outwards, having a vertex at the ischial tuberosity of t n and h and rota and with the fact that, for the purpose of simultaneous elongation femoral bone and control the formation of its arc, carry out a gradual traction of the proximal fragment of the femur medially and distal medially and downwards.

Description

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ABOUT

1U1 The invention relates to medicine, namely to traumatology and orthopedic surgery. A method is known for treating the consequences of congenital dislocation of the femur by osteotomy of the femur at the level of the ischial tuber and imparting to the femur a bent forka with an angle open-out (the so-called Shantz ostertomy) l. The disadvantage of this method is the OS-Guschaya after surgery shortening of the limb. There is also known a method of treating the viviha of the femur by double osteotomy of the proximal end of the femur, giving it an arcuate deformation, open outwards. The disadvantages of this method are the impossibility of postoperative correction of the deformity of the femur, its shortening. The aim of the invention is to simultaneously lengthen the femur and control the formation of its arch. The goal is achieved by the method of operative treatment of the consequences of congenital dislocation of the femur by executing the osteotomy of the femur and forming its arcuate deformity with an arc open outwards, having the apex of the arch at the level of the sciatic tuberosity, and the proximal femur of the femur is gradually clenched and distal medially and downward. The method is carried out as follows. Three proximal spokes are drawn through the proximal and distal metaphysis of the thigh. The planes of the spokes form with the sagittal plane of the thigh angles, open outwards and equal to 180 minus the amount of skew of the pelvis. All spokes are mounted on external supports apparatus Tsyiuarova. An incision in the upper third of the thigh exposes the region of the femur exposed. Oblique osteotomy is performed in the frontal plane from the top front - downwards and backwards, while the middle section of the bone is located at the level of the sciatic tubercle of the pelvis. On the 5-6th day after the operation, using the apparatus, begin a gradual, dosed reversal of the fragments one relative to the other: the distal end of the proximal detachment and the proximal end of the distal fragment medially, simultaneously diluting them, performed elongation. At s / g, they form an arcuate regenerate, open outwards with the apex at the level of the sciatic tuber of the pelvis. By distraction across all rods of the apparatus at a fast pace along the inner rods, the proximal and distal spokes are set parallel to each other. After the required elongation and the formation of an arcuate regenerate have been achieved, the apparatus is put into a fixation mode before the formation of a solid callus. Example. Sick M, 24 years old, was admitted about the consequences of congenital dislocation of the right thigh with a shortening of the limb by 6 cm. At the age of 1 year, the patient made an attempt of a closed reduction, having finished with relaxation. Upon receipt of complaints of lameness, in the hip. joint is limited to hip abduction. Positive Trendelenburg symptom, with a pelvic distortion, reaches 15 °. Sick operated. Through the proximal metaphysis of the femur, three intersecting spokes under 165 ° (180-15 °) were drawn to the horizontal plane, open outwards and downwards. Three intersecting spokes were also made through the hips of the femur at an angle of 1G5, open outwards and upwards. The proximal spokes are reinforced in the tensioned state on the arc, the distal spokes are fixed on the Ilizarov apparatus ring. The outer linear size of 4 cm from the base of the greater skewer cuts the skin, subcutaneous fiber, and fascia. The exposed area is exposed. The osteotomy and femur braid was made in the frontal plane from the top anterior to the bottom backwards for 6 cm. The wound has been sutured. On the 6th day after the operation, the reversal of the fragments and their mutual dilution were started by means of the dosed movement of the arc and the ring before placing them in a mutually parallel position. This was achieved by tightening the nuts of the rods located on the inner thigh at 1.5 mm per day, and the nuts of the rods located at the outside of 0.75 mm. The period of beats / life was 67 days, fixation - 85 days. After the clinical and radiological control, the device was removed. The transition to a full load on the operated leg after 2 months. after removing the apparatus. Control examination after 1 g, after discharge. Goes not chrome. Movement in the hip and elbow joints in full. The length is the same, the biomechanical axis of the limb is correct. In the case of a subgraphic examination, the coefficient of walking rhythm is close to normal, 97) When standing on the operated leg

310618054

Trendelenburg symptom is negative. The proposed method allows it to work in its former specialty, to lengthen the femur and manage to get married with the formation of bone regenerate.

Claims (1)

754) METHOD FOR OPERATIONAL TREATMENT OF CONSEQUENCES OF CONGENITAL DISPOSITION OF THE HIP by means of the postoperative osteotomy of the femur and the formation of its arched deformity with an arc open outwardly having an apex at the level of the ischial tubercle, characterized in that, in order to simultaneously control and extend the femur, gradual traction of the proximal fragment of the femur inward, and the distal inward and downward.