SU1357015A1 - Method of forming shin stump - Google Patents

Abstract

The invention relates to medicine, more specifically, to traumatology and orthopedics, and can be used in the amputation of lower extremities. The purpose of the invention is to preserve the skin-skin vessels, due to the fact that during the amputation they penetrate into the gap between the gastrocnemius and the soleus muscles, divide them among themselves, cut out a wide posterior skin-fascial-muscular flap (the skin, subject to fascia, skin calf muscle), impose nodal catgut subcutaneous-minor stitches along the edge of the flap circumference. Thus, the gastrocnemius muscle remains attached to the underlying fascia and subcutaneous tissue with the skin. Suturing around the circumference of a single posterior dermal-flap prevents damage to the perforating vessels, which is a major factor in the healing of a postoperative wound during the formation of a stump. ((L from the joint venture

Description

The invention relates to medicine, in particular to traumatology and orthopedics, and can be used in the amputation of lower extremities.

The aim of the invention is the preservation of musculo-cutaneous vessels.

During amputation, they penetrate into the gap between the gastrocnemius and the squamous muscles, divide them between themselves, cut out the wide posterior single skin-fascial-muscular flap (skin, the subject fascia. along the edge of the flap circumference.

Thus, the gastrocnemius remains attached to the underlying fascia and subcutaneous tissue with skin.

Example. Patient V., A2, was admitted with a diagnosis: a long-term nonhealing wound of the stump of the middle third of the right tibia. Amputations were performed 1.5 years ago for licorifying endarteritis. In the postoperative period, necrosis of the anterior skin flap occurred with the development of terminal tibial osteomyelitis. After 13 months, the patient was re-instrumented with cutting out a longer posterior skin-fascial flap and separating it from the gastrocnemius 1 MbEHiijbi. On the 3rd-second day after the operation, necrosis of the posterior skin and fascial flap occurred. Drug therapy, ligation - physical methods of treatment, necrotomy led to a gradual stabilization of the inflammatory process, but the wound did not heal.

After 4 months after the second operation, the proposed method is re-used. Outline the dimensions and lines of cutting out flaps. At the same time, the back flap is painted wide and long, and the front flap is short. On the medial surface with a scalpel bark puncture of the skin, subcutaneous tissue and fascia. Through the incision, the forefinger of the left hand penetrates into the gap between the gastrocnemius and the soleus muscles, stupidly separating VN11NPI Order 5917/3 Circulation 595 Subscription

Prod-polygr. pr-tie, Uzhgorod, st. Project, 4

They are crossed and, under the control of the finger, cross the skin, subcutaneous tissue, superficial fascia and gastrocnemius at the same level. Immediately along the circumference of the flap, thin suture of catgut imposes interrupted sutures connecting the subcutaneous tissue, fascia, and gastrocnemius. Get a single small flap. The latter is turned backwards. Nerves are treated with perineural administration of 1% novocaine and are highly truncated. The vessels are ligated and stitched. Tibial and fibula bones are sawed off, the tibial crest is cut down. Bone chips are treated with a file. Formed back musculo-cutaneous flap is covered with sawdust bone. The front and rear flaps sew together. Rubber graduates to sawdust bone. Aseptic dressing.

The postoperative period was uneventful. Healing by primary tension. After 18 days, prosthetics with a medical training prosthesis were performed. At present, she is using a permanent prosthesis. Works.

The overlap around the circumference of a single posterior dermal-flap seam prevents the damage of the perforating vessels, which is unavoidable during the formation of the stump, which is the main factor in the healing of the postoperative wound.

Claims (1)

Invention Formula The method of forming the lower leg stump by intersecting soft tissues with cutting out the posterior skin-flap, bone intersection, and microscopic plasty over sawdust, distinguishing with the fact that, in order to preserve the tiny-skin vessels, soft tissues and along the edge of the circumference of a single skin-mass: of the eternal flap, stitches are inserted connecting the subcutaneous tissue with the fascia and gastrocnemius.