SU1498476A1 - Method of treatment of esteomyelitis of heel bone - Google Patents

Abstract

This invention relates to medicine, namely to traumatology, and is intended for the treatment of osteomyelitis of the pith bone. In order to shorten the treatment time while maintaining the footing ability, the foot is opened by osteotomy of the lateral surface of the heel bone in the sagittal plane, a non-free bone flap is formed with a base in the plantar part, the lesion is removed and the defect is closed with a formed graft.

Description

The invention relates to medicine, namely to purulent surgery in the treatment of osteomyelitis of the exact bone.

The purpose of the invention is to reduce the duration of treatment while maintaining the support ability of the foot.

The essence of the method is as follows.

U-shaped incision of soft tissue is made on the outer surface of the heel. The horizontal part of the incision is directly under the external ankle on the spine of the entire heel, its ends are gently rounded and continue towards the bottom along the anterior and posterior edges of the heel, not income to the plantar surface 1.0-1.5 cm. fibula muscles are isolated and removed from the wound. The cortical plate is cut through the entire length of the soft tissue incision. By alternately inserting from the vertical parts of the corticotomy in the sagittal plane of two wide bits, a compact bone of 3-4 mm thick is cut off, keeping in contact with the soft tissues covering it, and a bone flap is formed on the feeding pedicle during removal of which a window in the cortical layer of exact bone. Through it

the window is removed by abnormal tissues; the flap on the feeding leg is placed in place and fixed with interrupted sutures on soft tissues. Impose the rear plaster splint - With careful modeling of the arch of the foot.

Example. Patient I., 52 years old. In 1953, when falling from a height, received a compression fracture of the bodies of the 1st and 2nd lumbar vertebrae.

In March 1976, a neurotrophic stratum was formed, the course of which was complicated by osteomyelitis of the pith bone. Outside the institute, osteomyelitis of the bone was operated 11 times. In NIITO 04.12.86 an operation was performed according to the described method. In the operation, the entire spongy bone is represented in the form of combs filled with purulent-necrotic masses, which are resected under vision control. A thin cortical plate with a prize of spot bleeding has been left. The postoperative wound healed by primary tension. Three weeks later, the gypsum splint was removed and the ankle joint physical therapy was started. After 1 month, the patient is allowed a limited load on the operated limb, after 1.5 months he walks with a full

(L

N

with oo

four

05

load. At the control examination after 5 months, the postoperative scar is gentle, mobile, painless on palpation, there is no fistula. The patient walks without a braid, with a full load on the operated limb.

When a bone flap is formed on the feeding leg from the outer lateral surface of the heel, most of the supporting walls of the heel bone remain intact, which slightly reduces the mechanical strength of the bone. This allows the operated limb to be included in the load without plaster fixation and to begin physical therapy of the ankle joint after the formation of the primary bone callus between the bone graft on the feeding pedicle and the maternal bed.

that is, after 3-4 sneakers. At the same time, treatment time is significantly reduced - by about 45-50 days.

Claims (1)

Invention Formula A method of treating osteomyelitis, pith bone by opening the lesion with the formation of a bone flap on the supply leg, removing the altered tissues with subsequent closure of the defect with a non-free graft, characterized by the fact that the side surface is osteotomy bones in the sagittal plane and form a flap with a base in the plantar part.