SU1463265A1 - Method of treatment of epiphysiolysis of the femur head - Google Patents

Abstract

This invention relates to medicine, in particular to orthopedics in the treatment of femoral head epiphyseolysis. The goal is to reduce the treatment time from 6-8 to 3-5 months with the prevention of external rotation contracture due to cutting off the greater trochanter, angular osteotomy in the sagittal plane of the intercavity area, taking into account the adjustable angle of correction, subperiosteal allocation of the tendons of the muscles of the external hip rotators, displacement of the middle fragment relative to the longitudinal axis of the neck and fixation of the greater trochanter.

Description

one

The invention relates to medicine, namely to orthopedics and traumatology, and can be used to treat epiphysiolysis of the femoral head.

The purpose of the invention is to reduce the duration of treatment with the prevention of external rotation contracture.

The invention makes it possible to shorten the treatment time with a warning, an external rotation contracture.

The method is carried out as follows.

An incision on the outer surface of the thigh begins from the middle of the distance between the anterior superior spine of the pelvis and the greater trochanter, skirting it from behind, and continues downward along the thigh. The wide fascia is dissected in the same direction. The subperiosteal expose the interversion region of the femur in front, outside and behind to the site of attachment of the hip joint capsule. Osteotomy markings are made according to the fabricated material. Thereafter, a flat bit produces an angular osteotomy according to the marking. The direction of the osteotomy from the outside inwards must correspond to the direction of the epiphysiopharyngeal angle. A large spit at its base is cut off with a grooved chisel and the place of attachment of the tendons of the muscles of the outer thigh rotators is attached to the Subperiosteal. As a result of osteotomy, three fragments of the femur are formed: proximal - the great trochanter attached to it annual muscles, distal, on which two osteotomy planes are formed, anterior and posterior, the angle between them, and the middle fragment - the intertrochanteric region, the neck and the epiphysis, on which the angle between the anterior surface of the intertrochanteric region and the anterior osteotomy plane and between the osteotomy planes was formed. With the help of bone holders, a correction was made by rotating the middle fragment anteriorly before aligning the above angles. As a result of this movement, the front surface

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Zvertelnoy area tightly in contact with the anterior plane of osteotomy on the D1 steel fragment. All three fragments in the corrected position of the fastener - south by any intramedullary rod inserted from the side of the greater trochanter or the middle and distal fragments are fixed by an L-shaped fixer, and the large trochanter is attached to its anatomical structure with a screw. Lay layer-by-layer seams of ke tgutom and silk. Drotational sa-ps - to prevent rotational hfcjix movements in the hip joint. Example. Ill G., 12 years old, with juvenile epiphysiolysis of the head of the left thigh. Sme-Shch of an epiphysis of a kzad on 56 °, an epiphysiophysiological angle 125 °. A degree of correction of 60 ° is required.

Operational intervention on the left thigh produced as follows.

A template was made with a posterior anterior osteotomy deviation of 60 ° and an angle of 120 ° between the osteotomy planes. C; a corner-shaped incision along the outer surface of the left thigh. Subperiosteal allocated the intertransfelling area. Attached the template to the outer surface of the intertrochanter area, made markings octeoTOMnn. Thus, the anterior (|) intertrochanter osteotomy is deflected from the anterior surface of the intertrochanter region by 60 °, and the posterior osteotomy plane is 120 ° from the anterior angle. Ds (a lot of large skewers were cut off at its base and the subperiosteal space was separated (attachment of the muscles of the external rotatho rophs of the thigh). 5 anterior surface of the intertrochanteric region and anterior osteotomy plane on the middle fragment with an angle formed by the osteotomy planes on the distal fragment. this vrasheni

 the anterior surface of the intertrochanteric region fits snugly to the anterior osteotomy on the distal fragment. In the corrected position, the middle and distal fragments were sealed with an L-shaped clamp, and the large skewer was fastened with a win 15 volume. The wound was layer-wound tightly. The result of the operation: after correction, the residual posterior displacement is 12 °, which is permissible (the correction of displacement is made by 79%).

The method made it possible to reduce the duration of treatment from 6-8 months to 3-5 months, with the warning of external rotation contracture.

Claims (1)

Invention Formula 25 A method of treating epiphysiolysis of the femoral head by osteotomy in the intertrochanter region, cutting off the greater trochanter, displacing the middle fragment relative to the longitudinal axis of the cervix, fixing the greater trochanter, characterized in that 30, in order to shorten the treatment time by preventing external rotation contracture, an angular osteotomy is performed in the sagittal plane, taking into account the adjustable correction angle, and the subperiosteal limb tendons are removed from the external thigh rotators.