SU1593641A1 - Method of treating elbow joint ankylosis - Google Patents

Abstract

This invention relates to medicine, in particular to orthopedics and traumatology in the treatment of elbow ankylosis. In order to ensure rotational movements of the forearm, the distal section of the humerus is resected, the orthotopic demineralized bone-cartilage graft of the cap with collateral ligaments is replaced with it, the bridges with the forearm are attached, the limb is immobilized with the subsequent development of joint movements.

Description

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The invention relates to medicine, namely, to traumatology and orthopedics, and is intended to restore lost movements in the elbow joint.

The aim of the invention is to provide rotational movements of the forearm. .

The method is carried out as follows.

A back longitudinal incision of 15 cm in length with an angular dissection of the triceps tendons of the mouth and the release of the ulnar cavity from the groove of the ulnar nerve. The distal end of the humerus is skeletonized and machined using cutters so that it approximately corresponds to the internal cavity of the graft. In the lateral parts of the humeral metaphysis in the anteroposterior I

The board forms two parallel channels with a diameter of 4–5 mm. Then, the demineralized osteochondral cap is put on the prepared stump and fixed with the help of the first and posterior cortical strips of the graft, held towards each other through the bone canals. Demineralized strips at the exit of the channels are fixed with catgut sutures. The formed joint is fastened with a capsule type. Lateral and medial collateral ligaments of the graft to soft tissues are stitched. The operation is completed by suturing the triceps of the sacrum and layer-by-layer wound closure tightly. Drainage tubes are inserted into the joint cavity.

Example. Patient Yermenev, born in 1960, July 3, 1987

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ABOUT)

lip fall on the street got a closed splinter fracture of the left olecranon with vgoihom forearm anteriorly. The dislocation was set in one of the district hospitals of the Leningrad Region with the subsequent immobilization of the lower limb with a plaster cast. Fusion fracture did not occur.

February 9, 1988, after 7 months after the injury, metal ostesynthesis of the ulnar process was made, with bone auto-spasticity i Immobilized with a plaster dressing during the Snake. Fusion fracture achieved. However, contracture of the elbow of yustav developed with an amplitude of movements in the range of 95-125 °. Especially sharply bounded is the rotadi of the forearm.

October 20, 1988. The elbow joint was performed. To do this, we have a longitudinal incision and dissection of the triceps tendons in 1) the cavity of the elbow joint has been opened. There is no cartilage cover on the articular surfaces of the joining bones. With the help of cutters, the distal end of the humerus was processed in such a way that it corresponded to the internal cavity of the demineralized transplant cap. When the latter was fitted to the stump of the humerus, one of the fixing strips was detached from the front surface of the Cap. In this connection, the graft was fastened to the recipient's bone with the help of two Kirchner needles. The previously separated muscles are hemmed to the humeral humerus. Lateral and medial lateral transplants of the graft are crosslinked with and partially

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with muscles located on the bone of the forearm. After that, the formed joint is covered with a fascia of the capsule type. Fixation of the fascia to the soft tissues of the humerus and the bones of the forearm was carried out with catgut sutures. After suturing the fragments, the triceps tendons; muscles and insertion of drainage tubes, the wound is sutured in layers tightly. Imposed gypsum on- het for a period of two weeks. After surgery, rehabilitation treatment was performed.

The result of the operation after 5 months. (March 22, 1989): the patient is being prepared for discharge to work, the amount of movement. The scientific research institutes in the elbow joint are full, the rotational movements of the forearm are restored, the strength of the flexors of the elbow joint is normal, the strength of the extensors is reduced, small painful sensations in the operated joint appear only during physical exercise on the Pku.

Ph o rmula invention

A method of treating ankylosis of the elbow joint by resection, replacement of the distal humerus, immobilization with subsequent development of movements, characterized in that, in order to provide rotational movements of the forearm, the distal section of the humerus is replaced by orthotopic demineralization of bone marrow hollow graft with collateral ligaments with their subsequent connection to the bones of the forearm, the joint is closed with a biological film.

Claims (1)

Claim A method of treating ankylosis of the elbow joint by resection, replacing the distal humerus, immobilizing with the subsequent development of movements, characterized in that, in order to provide rotational movements of the forearm, the distal part of the humerus is replaced with an orthotopic demineralized bone-cartilaginous hollow graft with a collateral ligament followed by connecting them with the bones of the forearm, the joint is closed with a biological film.