SU950341A1 - Method of making endoprosthesis of femur proximal part - Google Patents

Description

(54) METHOD FOR ENDOPROTESIZING A PROXIMAL

HIP DEPARTMENT

one

The invention relates to medicine, in particular to methods of reconstructive surgery and traumatology.

The known method of endoprosthesis replacement of the proximal femur by removing the diseased head, neck and proximal part of the femur, making an impression during the operation on the extracted head and filling its cavity with self-hardening plastic, Q loading into the proximal end of the prosthesis shaft, setting the specified angle of the head and fixing the position of the rod and complete freezing of the prosthesis 1.

However, the known method does not allow the formation of an individual artificial head of the thigh with a defect in the bone substance of the femoral head on the basis of aseptic necrosis or its fracture. This is due to the changes in the shape of not only the pincer, but also the various sections of the femoral head, which excludes the possibility of creating a full-fledged impression for the subsequent manufacture of the necessary form of an artificial head.

The aim of the invention is the restoration of biomechanical relationships and joint function.

This goal is achieved by implementing the endoprosthesis method of the proximal femur by removing the diseased head, neck and proximal femur, making an impression during the operation on the extracted head and filling its cavity with self-hardening plastic, immersing the prosthesis into the casting of the proximal end the specified angle of the head and the fixation of the position of the rod before the prosthesis is completely cured, in the presence of a bone tissue defect in the remaining resections of the pathological focus of a part of the head make holes, thermoplastic material is inserted into them, a head defect is made, and the shapes and sizes of the head of the healthy thigh are simulated by X-ray.

Claims (1)

The method is carried out as follows. Backstage Kocher expose and cut through the capsule of the hip joint. The remainder of the femoral head is removed after the screw is inserted into it from the outside (from the side of the neck fracture). The base areas of the femoral neck are resected at the level of the intertrochanteric region. In the defects of the femoral head, both from the external part of the femur and after removal of the necrotic tissues, in the place of aseptic necrosis, an awl is made in the awl, into which thermoplastic material (for example, wax or acrodent) is tightly inserted and the missing parts of the head are formed. The addition of the missing parts of the femoral head is carried out taking into account the shape and ratio of the bones forming a healthy hip joint. After modeling the formed areas, the head is lowered into a rubber cup with diluted stomalgin. Then, the upper sections of the stomalgin mold are dissected in 2-3 places, which makes it easy to remove the head of the patient’s thigh from the formed impression. A mixed mass of polymer and mono-self-hardening plastics, such as acrylate oxide, are poured into the form of stomalgin. The cervical part of the metal rod of the endoprosthesis is immersed in the not yet solidified polymer mass at the required angle. At the end of the polymerization, an artificial head is extracted from the stomalginic form, which corresponds exactly to the size of the patient's thigh head. The stem of the endoprosthesis is tightly inserted into the pretreated mstaphyseal and diaphyseal parts of the femur. The artificial head is then placed in the acetabulum of the patient and the wound is sutured in layers. Immobilization of the operated limb was carried out with a derotational boot. The proposed method allows to create the exact shape and size of the femoral head before the pathological change, which ensures the restoration of biomechanical ratios, which reduces the coefficient of friction between the artificial head and the acetabulum of the patient, which prevents destruction of the walls of the acetabulum and allows the artificial prosthesis head to move in directions close to physiological, thanks to its individual form. The method of endoprosthesis replacement of the proximal femur by removing the diseased head, neck and proximal femur from the pathological, making an impression head during the operation on the extracted head and filling it with a self-hardening plastic, immersing the casting of the proximal end of the prosthesis, setting the specified angle of the head and fixing the position of the rod until the prosthesis is completely cured, characterized in that, in order to restore the biomechanical relationships and the function of the joint, and the presence of a bone defect, preliminarily in the part of the head remaining after the resection of the pathological focus, holes are made, thermoplastic material is inserted into them, the head defect is replenished and the shape and size of the head of the healthy thigh are simulated by X-ray. Sources of information taken into account during the examination 1. USSR author's certificate No. 706076, cl. A 61 B 17/00, 1978.