SU971277A1

SU971277A1 - Method of arthrodesis of talocrulal articulation

Info

Publication number: SU971277A1
Application number: SU711713544A
Authority: SU
Inventors: Николай Алексеевич Шугаров; Виктор Васильевич Лапин
Original assignee: Рязанский медицинский институт им.акад.И.П.Павлова; Рязанская Областная Клиническая Больница N3
Priority date: 1971-11-09
Filing date: 1971-11-09
Publication date: 1982-11-07

Description

(54) СПОСОБ АРТРОДЕЗА ГОЛЕНОСТОПНОГО (54) METHOD OF ARTHRODESIS

1one

Изобретение относитс к области медицины , а именно ортопедии, и может быть использовано при лечении заболеваний суставов.The invention relates to the field of medicine, namely orthopedics, and can be used in the treatment of diseases of the joints.

Известен способ артродеза голеностопного сустава путем резекции суставного хр ща, фиксации и компрессии костей , образующих сустав, спидами с упо| ными площадками 11 .There is a method of arthrodesis of the ankle joint by resection of the articular cartilage, fixation and compression of the bones that form the joint, aids with support | sites 11.

Однако известный способ не обеспечивает высокой надежности костного сращени и сроки Лечени длительны.However, the known method does not provide high reliability of bone fusion and the treatment time is long.

Целью изобретени вл етс повышение надежности костного срашени и сокращение сроков лечени .The aim of the invention is to increase the reliability of bone marrow and shorten the treatment time.

Цепь достигаетс тем, что при осуществлении способа артродеза гх леностопного сустава путем резекции суставного хр ща, фиксашш и компрессии костай, образующих сустав, спицами с упорными площадками дополнительно резецируют ди стальный межберповый синдесмоз, а затем через обе берйовые кости на уровне резе СУСТАВАThe chain is achieved by implementing the method of arthrodesis of the hf joint of the lenticular joint by resection of the articular cartilage, fixation and compression of the bone that form the joint, with the spokes from the stubborn areas, the distal interbarpal syndesmosis is additionally resected, and then through both the bones at the level of the rez SUSTAVA

хшрованного синдесмоза провод т две спицы .с упорными площадками перпендикул рно оси голени в двух взаимно противоположных направлени х.The combined syndesmosis conducts two knitting needles with retaining pads perpendicular to the axis of the tibia in two mutually opposite directions.

На чертеже изображен голеностопный сустав после резекции суставного хр ща и нижнего межберцового синдесмоза и фиксации костей голени спицами с упорными площадками.The drawing shows the ankle joint after resection of the articular cartilage and the lower tibial syndesmosis and fixation of the bones of the tibia with the spokes of hard areas.

fQ Способ осуществл ют следующим образом .The fQ method is carried out as follows.

Сустав вскрывают передним срединным разрезом. Рассекают переднюю и заднюю межберцовые мембраны, что обеспечиваетThe joint is opened by the front midline incision. Cut through the anterior and posterior tibial membranes, which provides

,5 хорощий доступ к суставным поверхност м. Св зки, прикрепл ющиес к таранной косга , не пересекают, чтобы не нарушать ее кровоснабжение. Стопе придают положение максимального подошвенного сгибани ., 5 good access to the articular surfaces. The ligaments attached to the ramming are not crossed so as not to disturb its blood supply. The feet are given a position of maximum plantar flexion.

20 Суставной хр щ с вилки голени, блока и лодыжковых поверхностей таранной кости удал ют до губчатого сло кости. После такой манипул ции размер вилки голени20 The articular cartilage is removed from the fork of the tibia, the block and the ankle surfaces of the talus to the spongy layer of the bone. After this manipulation, the size of the fork is

Claims

becomes significantly larger than the size of the talus. To eliminate the inconsistency of these sizes, bone tissue is removed from the outer surface of the tibia and from the inner surface of the bone fiber at the level of the lower inter-biliary syndesmosis until the resected ankle surface fits tightly to the resected Ankle surface of the talus. 19 Two needles, 1 and 2, reinforced in ug 3, with retaining pads 4 and 5, and the tibia of the tibia at the level of the lower tibiotropic syndesmosis, are held; One needle - from the side of the tibia, the other - from the side of the fibula. The blunt ends of the spokes above the thrust pad bite, thrust pad immersed under the skin. The protruding sharp ends of the spokes are attached to a Kirchner arc for skeletal stretching. The two spicates are uniformly tensioned by the spokes. The helper at this time, with pressure on the heel area along the axis of the limb, tightly presses the talus to the tibia. In this position, further on the sting of cntiv. densely fasten the tibia bones between. with ankles and their ankles with an ankle bone. All this is done directly under the control of the vlag, the tension of the spokes is checked with a calibrated key. After the required tension and the approaching of the bones, the arc is firmly fixed to the spokes. The wound is sutured in layers. Lay the plaster boot down to the middle 1/3 of the thigh. In the postoperative period, the tension force of the spokes is checked with a calibrated key. All stages of the operation are carried out directly under the eye's contrahem. The incidence of the ribs of the ribs syndesmosis eliminates the discrepancy between the sizes of the fork of the tibia and the talus, which ensures tight contact and participation in the process of fusion of all the bones forming the ankle joint. The use of knitting needles with stubborn pads and holding them through the tibia at the level of the tibia syndesmosis creates compression between the resected bone surfaces in the area of the tibia syndesmosis, the ankles and the ankle surface of the talus. The rapprochement and compression between the block of the talus and the lower surface of the bluff bone occurs by the force of contraction of the mandibles. By preserving the talonebibular cords in which blood vessels pass to feed the talus, prevent aseptic necrosis of the talus. The proposed method increases the reliability of bone bonding and reduces the treatment time. Claims of the method of arthrodesis of the ankle bustle by resection of the articular cartilage, fixation and compression of the bones of the joints of the joint using the spokes with stubborn areas, characterized in that, in order to increase the reliability of the bone sprout and shorten the treatment time, the distal inter-tibial tubercula smphis is also resected, and the shafts of the ankle are replaced. The bones on the level of the resected syndesmosis conduct two knitting needles with stop pads perpendicular to the axis of the tibia in two mutually opposite directions. Sources of information taken into account prn examination 1. Yusupov F. See Bakhtnoznn F. Sh. New compression method. arthrodesis of the ankle joint of the joint with the help of the spokes with hard areas. - In Sat. Prevention, klnnka n treatment of injuries. Works of KNIITO, TOMXtll, Kazan, 1968, p. 179.