SU1438725A1 - Method of treatment of false joints - Google Patents

Abstract

This invention relates to traumatology and orthopedics. The purpose of the invention is to reduce the time of fusion. The place of the false joint is exposed, forming the cuff of soft tissues so that it includes bone tissue of the periosteal callus in the form of non-free lamellar autotransplants around the perimeter of the false joint. The fracture site is disconnected. The fragments are composed and fixed. A bed is created around the joint by detachment of the superficial cortical layer. Lamellar autografts are moved, placing the ends on the surface of the perceiving bed subcortically. The resulting conglomerate is overlapped by the underlying periosteum and muscles.

Description

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 IND ate

This invention relates to medicine, namely to traumatology and orthopedics.

The purpose of the invention is to reduce

terms of accretion to the account of acceleration

bone regeneration in hypertrophic false joints.

The method is carried out as follows.

Expose the place of the pseudarthrosis, forming a soft cuff.

tissues so that its composition includes the bone tissue of the periosteal callus in the form of non-free lamellar autografts around the perimeter of the false joint. Via

The chisels uncouple the fracture site and open the bone-marrow canal of fragments. The fragments are compared and fixed with a metal rod that was previously bent, taking into account the physiological curvatures of the channel. A bed is created around the false joint by detachment of the noBepxHOCTHorq cortical layer, the lamellar autografts are moved by placing the ends on the refreshed surface of the perceiving bed subcortically. The resulting conglomerate is overlapped by the underlying periosteum and muscles. The wound is sutured in layers tightly.

Example. Patient R., 22 years old, was admitted to the clinic about complaints of pain in the area of a left hip fracture, hip deformity, a decrease in the support function of the leg. Clinically and radiologically defined, a hypertrophic false joint of the left thigh with a fracture of the fragments, varus deformity, a fracture of a metal fixator. Under general anesthesia, in a position on the side, the external access layer of the false joint is exposed in layers. Chisels on the outer side of the periosteal callus have cut longitudinally tissue within 4 cm proximal and distal from the zone of the false joint to the bone. The formation of bone plates from the cortical layer of bone associated with periosteal callus along the bone perimeter was performed. A cuff on the supplying leg is formed, including autoplates, periosteal callus and underlying soft tissues. The ends of fragments are selected, the broken clamp is removed. An autopsy of the medullary canal was performed, the ends of fragments were processed. The latter are mapped and retrogradely fixed by an intramedullary metal pin. On the periphery of the false joint in both fragments, a bed chute was prepared for subcortical fixation of autografts, after which the grafts were inserted into the bed. The periosteum is detached within the limits of healthy tissue. The area of the false joint is covered with a cuff on the supply leg and the periosteum. Around

sutured muscles. The wound is sutured in layers tightly. Established drainage system. Imposed coxit gypsum dressing. On control radiographs of the thigh, the position of the fragments is correct.

The postoperative period was uneventful. Radiographically after 6 months the fracture line was not determined, a pronounced callus was visible. Fracture fusion was clinically determined.

Thus, the use of bone autografts on the periosteal callus pedicle allows to accelerate the fusion of the false joint and thereby reduce the treatment time.

Claims (1)

Invention Formula A method of treating false joints by exposing and reproducing fragments, their intraosseous fixation, creating a bed in the area of the fracture with a subcortical placement of bone in it graft with overlap by the periosteum and surrounding muscles, about t - characterized by the fact that, with -. Lew reduction in terms of fusion due to accelerated bone regeneration in hypertrophic false joints, As a graft, fragments on the supplying leg of the peristicular corns are used, which are placed around the entire circumference of the bone.