SU1189437A1 - Method of plasty of large bone cavities - Google Patents

Abstract

METHOD FOR PLASTICS EXTENSIVE bone cavity by sekvestrnekrektomii, brefoplastiki, characterized in that, with a view to preventing relapse brefoplastiku oszptsestvl dissolved platelets arch fetal skull, which is secured in the longitudinal grooves of the cavity formed over the entire length of the remaining bone of the tube wall, and a extramedullary angles.

Description

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The invention relates to medicine, namely to purulent surgery.

The purpose of the invention is to prevent the recurrence of the disease.

The method is carried out in the following manner.

A layer-by-section incision of soft tissue is made above the pathological focus of the femoral or tibial bone. The periosteum is dissected in the longitudinal direction, exfoliated to the side, the altered bone tissue is exposed, and in the form of a trough resection is removed together with sequesters and purulent granules. The remaining vast cavity is washed with physiological saline solution with one of the antibiotics to which the microflora is sensitive in the focus. Through the grooves of the cortical plate of the embryo are cut through the remaining walls of the bone tube. Plasticization of the extensive bone cavity of approximately 2.5x21.0 cm was made using the plates of their bones of the cranial vault 22-24 weeks. Possessing elastic properties, the plates are easily compressed and, in compressed form, are placed into the grooves with ends. By virtue of their elasticity, straightened, they are inserted into the grooves in the opposite walls of the remaining bone tube, replacing the removed cortical plate.

Example. Irina B, 16 years old, was admitted with exacerbation of chronic hematogenous osteomyelitis of the left thigh. When entering the lower third of the left femur on the outer surface, two postoperative scars, 15.0x2.0 cm and 10.0x2.0 cm (sequestrectomy was previously performed). The inner surface in the lower third of the postoperative scar is 15.0x1.5 cm, here it is also determined the infiltration of 5.0x8.0 cm, dense and painful. The skin over it is hyperemic, fluctuation is determined. In the day of admission under local anesthesia, an abscess dissection was performed, and about 35.0 cm of pus had developed. Subsequently, it is produced within 2 months. antibacterial therapy, restorative treatment. In fistulography, a contrasting substance, along a tortuous path, approaches the lower third of the femur, penetrating into the medullary canal. Visible multiple large

and small cavities. Under intravenous anesthesia, radical sequesternectomy of the left femur with plasty of the residual cavity is performed with a bone transplant from the bones of the cranial vault.

On the outer surface of the left femur with excision of the old operative scar, a soft tissue length of 24.0 cm is cut. The periosteum is dissected in the longitudinal direction. On the border of the middle and lower third of the femur, directly under the periosteum, is intimately connected with it along the back surface. femoral sequestrum 2.5 x x 4.0 cm plate-shaped, which is removed. The cortical plate in the area 3.0x21.0 cm is knocked out by an outer-back surface with a chisel. The medullary canal is narrowed, the femoral bone is thickened, sclerosed. In the bone marrow channel multiple cavities with septa of sclerosed tissue. The granulations from the bone cavities are removed along with small sequesters. A plastic was made by the bones of the calvaria of the embryo of the mother, 26 years old, a cesarean section about placenta previa. The bones of the skull are fixed to the lateral remaining walls of the bone tube in a compressed form in the longitudinal grooves made by an electroplate. Reliability of fixation is achieved by straightening the plates and inserting their ends into the grooves.

On the R-gram is visible extensive cavity after sequestrectomy. The cavity is washed with 0.9% sodium chloride solution. A microirrigator with lateral holes under the periosteum is inserted into the wound through separate passages. Yioxidin solution is injected through a microirrigator. Layer wound seam, sterile dressing, plaster back longongue.

Wound healing by primary tension. Discharged home through the month in a gypsum dressing.

When viewed after 4 months no complaints, the postoperative scar is calm. Contrast remains are visible on the R-gram, the integrity of the bone tube is restored almost throughout. Gypsum dressing is removed. After 10 months there are no complaints from the day of operation. Limb movement in full

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volume. Goes without lameness. The cavity of the bone tube is not traced on the R-gram Tomical integrity, but the tube has also been restored throughout the restoration of the bone marrow. In this case, regeneration occurs much faster.

The method makes it possible to note the following is the medullary canal.

a positive effect. For plasty of an extensive bone strip, three or more plates from the

bony plates of the cranial vault, behind the bones of the vault of the skull of the embryo. CnocoiS

Fortified aa margins of bone tubes, - JQ allows you to avoid relapses, and you will not only be able to recover from anaing.

5 8 months, by this time of resurrection

Claims (1)

METHOD FOR PLASTIC EXTENSION OF BONE CAVITY by sequestration necrectomy, brephoplasty, characterized in that, in order to prevent relapse, brephoplasty is performed by fetal skull vault plates, which are fixed in the longitudinal grooves of the cavity, made along the entire length of the remaining walls of the bone tube, and placed extra. Q0 CO hU ω ^ 1>