SU1107836A1 - Method of operative access to the elbow joint - Google Patents

Abstract

A METHOD FOR OPERATING ACCESS TO THE ELBOWS, including cutting off the olecranon, characterized in that, in order to shorten the duration of postoperative immobilization of the joint, the incision of the olecranon is performed in the frontal plane to produce a longitudinal bone graft on the supply legs.

Description

00 with

C55

The invention relates to medicine, namely, to traumatology and orthopedics, and can be used in surgical interventions on the elbow joint for its diseases, where capsules-sinewies and injuries, such as block and capitate of the humerus and T and V-shaped distal fractures, are shown. humerus.

There is a method of operative access to the elbow joint, according to which a horseshoe incision is made along the back surface of the shoulder and the elbow joint, with the base facing upward, the ulnar nerve is severed, the soft tissues and the joint capsule are dissected on both sides of the ulnar process, the ulnar process is crossed and the mouse is turned upwards eterno-aponeurotic flap, opening wide access to the lower third of the humerus and the elbow joint 11 The disadvantage of this method is the discontinuity of the musculo-esophagus ata that trbuet long periods of joint fixation after surgery, causing the formation of intra-articular adhesions.

The purpose of the invention is to reduce the period of postoperative immobilization of the joint.

The goal is achieved by the method of operative access to the elbow joint, which includes cutting off the ulnar process, dissecting the ulnar process in the frontal plane to obtain a longitudinal bone graft: a feeding legs.

The method is carried out as follows.

In the patient's position on the back with a roller with a thickness of 10-15 cm under the shoulders from the side of the operated limb, the latter is placed on an orthopedic support for the upper limb fixed to the operating table in the flexion position of the forearm at an angle of 80-90 ° or the limb is placed in the required position on the chest the patient. On the upper third of the shoulder impose elastic harness.

Then by a longitudinal arcuate skin incision and subcutaneous

cellulose on the posterior surface of the elbow joint produces a frontal osteotomy of the olecranon, having an arcuate shape in cross section, and a longitudinal bone graft is carved out of the posterior surface of the ulna and on the soft legs, including the extensors of the forearm, located on the shoulder and forearm. . The subperiosteal legs that are formed by feeding are separated from the humeral and ulnar bones for 3-7 cm. Next, the forearm is shifted to the full extension position, the flap is shifted outward and anteriorly, turning it around the longitudinal axis by 170-190 °. Cut the joint capsule from the ulna. From the inside of the joint, the soft tissues from the condyle of the humerus from the external and internal surfaces are peeled off. After that, the forearm is placed in the position of the maximum possible supination and fully flexes it, stretching the articular surfaces. After surgery, the musculoskeletal flap is put into place, moving medially and posteriorly

0 to full flexing of the forearm. Layered seams on. Immobilization of soft girdle dressing in the position of flexing the forearm at an angle of 70-90 for 10-12 days. Movement in the joint starts at 3-5 days.

Approx. The patient was admitted with complaints of pain during exertion in the right elbow joint, restriction of the range of movements in the joint. A year ago

p at work while felling the forest received a blow to the right forearm with a log.

Local status: the right elbow joint is enlarged, the ends are deformed. Movement: bending - 160 bending 85. Rotational movements within 15 ° in both directions. Atrophy of the shoulder 2 cm, atrophy of the forearm 1.5 cm, noticeable hypotrophy of the hypothenary. Hyposteses in the zone of innervation of the ulnar nerve on the hand. On the atropneumogram, the articular fissure is narrowed, cranial. In the anterior and posterior torsions of the joint, the Kostis-cartilage is circularly shaped from 0, 5 cm to 1, see. Diagnosis: post-traumatic arthrosis of the elbow joint, extensor contracture of the joint.

Claims (1)

METHOD OF OPERATIONAL ACCESS TO THE ELECTRIC JOINT, including cutting off the ulnar process, characterized in that, in order to shorten the period of postoperative immobilization of the joint, cutting the ulnar process is done in the frontal plane to obtain a longitudinal bone graft on the supply legs.