SU1694115A1 - Method for executing autocranioplasty - Google Patents

Abstract

The invention relates to medicine, namely to neurosurgery. The method makes it possible to reduce destructive changes in the bone flap with delayed plastic surgery. And this is achieved by implanting the bone flap on the musculoaponeuroticus at the edge of the defect under the skin aponeurotic layer of the skull.

Description

The invention relates to medicine, namely to neurosurgery,

The aim of the invention is to reduce the destructive changes in the bone flap with delayed plastic.

The method is carried out in the following manner.

At the head, in the projection of the pathological focus, a horseshoe-shaped incision of the skin is made, skin and flap is folded back to the base of the incision. An incision is made in the musculoaponeurotic and periosteal layers of soft tissues along the entire length of the borders of the proposed bone flap, except for the area where the continuity of the feeding leg will be maintained. The bone graft is sawed out with maximum preservation of soft tissues near the cutting line. At the base, covered by the muscular-aponeurotic-periosteal leg, the bone flap is cracked in the usual manner. Then, receptions are made for further access and intervention on the pathological focus of the brain. At the end of this operation, before closure of the skin frame under the skin aponeurotic layer of the head at the edge of the bone defect, the bed is formed in a blunt way, exfoliating the skin with the superficial sheet of the fascia of the head from the underlying tissues. The musculoaponeurotic-periosteal leg of the bone flap is mobilized and the bone flap is laid in the formed bed and as much as possible relieve the defect of the cranial vault from overlapping it with the bone flap. By suturing the skin wound, the decompressive craniotomy is completed.

In the second surgery, the skin is cut along the line of the previous incision, skin flap is mobilized to the base. Bone flap is mobilized with a musculoaponeurotic-periosteal leg. Free the margins of the bone defect. Put the bone flap in place. The wound is sutured in layers.

Example. Patient V., 26 years old. Clinical diagnosis: closed craniocerebral injury with contusion suppression of the brain with acute epidural hematoma on the right. Fracture of the skull vault on the right. A decompressive craniotomy of the skull was made on the right, the hematoma was removed, a bone graft was implanted on the musculoaponeuroticus supraparticle pedicle under the skin aponeurotic layer of the head. It is necessary to measure that, due to fractures, the bone flap was divided into three fragments, in two bone fragments

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failed to preserve the supply leg due to periosteum detachment hematoma. The largest bone fragment retains its musculo-aponeurotic-periosteal leg, it was always sufficiently nourished and underwent fewer destructive changes, as was seen from the difference in the density of images on the radiograph.

The postoperative course is smooth. After removal of sutures and regression of cerebral symptomatology, the patients were discharged for outpatient treatment. The second step is to close the defect with the cherersh autograft on the muscle-aponeurotic-periosteal

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stem produced after 2 months. The postoperative period without complications.

Claims (1)

Invention Formula Method autokranioplastiki by compressive de- craniotomy, bone graft implantation in soft tissue with subsequent reimplantation, characterized in that, to reduce the destructive changes in the bone flap in delayed plastic, it cuts out on musculoaponeurotic-nadkostnmch- hydrochloric leg and implanted at the edge of the defect under the skin-aponeurotic layer of the head.