A method for predicting the optimal correction of the deformity of a limb

 

(57) Abstract:

A method for predicting the optimal correction of the deformity of the limb, is intended for use in medicine, particularly in orthopedics, to predict the optimal surgery for correction of congenital or acquired deformities of limbs. The proposed method can predict the optimum variant of the osteosynthesis and modes of correction of various deformities of limbs to restore its functionality by using computer programs. The program contains a mathematical algorithm to construct three-dimensional models of the bones and their mappings. To perform calculations and plotting using the average standard deviation of the axis of the deformed segment from its correct spatial axes. 4 Il.

The invention relates to medicine, in particular to orthopedics, and can be used to predict the optimal surgery for correction of congenital or acquired deformities of limbs.

The complex anatomical and functional abnormalities resulting from development S="ptx2">

Currently there is no clear justification for the approach to selecting certain criteria, such as peak strain, plane perform osteotomies, the level and number of osteotomies, the required size of the extension segment and limb in General, we obtain for the correction of deformation, which constitute in the aggregate a mathematical algorithm used to predict the correction of the limb.

A known method for determining the plane strain, in which the x-rays produced in the standard positioning of the limb, will detect the deformation in both planes, and for determining the plane strain using the graphical method [1].

There is a method to determine the number and levels osteotomies included in the mathematical algorithm on the radiograph, made in the plane of maximum deformation, which produces skiagram and determine the point of maximum deflection axis of the deformed bone from its normal anatomical axis of the segment and a biomechanical axis of the entire deformed limbs, with skiagram put line numbers and levels osteotomies.

However, the known method requires additional planar rentgenographies limb to predict the optimal osteosynthesis and modes simultaneous correction of various deformities.

In this task, the present invention is to provide such a method of forecasting, which would have allowed, depending on the mapping of spatial models deformed and fixed the bones of the individual patient, to choose the optimal variant of the osteosynthesis and modes simultaneous correction of various deformities of limbs to restore its function.

The problem is solved in that in the method for predicting the optimal correction of the deformity of the limb, including the construction of models of deformed limbs and extremities are normal, their comparison and processing of the data, build models is carried out in the form of spatial images and calculations for mathematical and plotting perform on the basis of the averaged standard deviation of the axis of the deformed segment and/or limbs from the correct biomechanical and anatomical axes.

In Fig. 1A. presents the x-ray bones deformed limbs in 2 perpendicular planes; Fig. 1B. - x-ray bones deformed limbs in 2 perpendicular planes, after computing the spine with printed zechusim planes; Fig. 3A. diagram modeling provisions deformed limbs in space; 3b. diagram illustrating the number and levels osteotomies; 3V. the results of calculations; Fig. 4 scheme of the optimal layout of the apparatus transosseous fixation.

The proposed method for the prediction of the optimal correction of the deformity of the limb is as follows.

On admission the patient perform a standard (forward and lateral) x-rays deformed extremities (see Fig. 1A,b) and skiagram, printed with cutting planes (see Fig. 2), in which the computer calculates a volumetric model of the bone.

The spatial three-dimensional model of the bone cut into a number of planes lying at the same distance relative to each other. The number of such points is equal to the number of clipping planes, and are they evenly.

Calculations performed on the basis of the averaged standard deviation of the axis of the deformed segment from its correct biomechanical axis.

The average standard deviation of the axis of the deformed segment is calculated using the mathematical expression:

< / BR>
where

S - .

Ai, ai- total value of lengths of the deformed segment in the frontal plane to the straight axis.

Bibi- total value of segments in the sagittal plane to a straight axis.

n is the number of dots formed by cutting planes.

So, by the known height of the bone, a certain number of points evenly spaced along the length of the bone and the distance from the axis point to the axis of the bone, the computer simulates the spatial position of the deformed and normal bone (see Fig. 3 a,b,C).

Determining the value of elongation produces computer after determining the level and number of upcoming osteotomies. The elongation depends on the diameter of the bone in the place of the cross section and the angle of deformation. Depending on the level of the osteotomy, the number of true plane strain and elongation values for each patient choose the layout of the apparatus, allowing the elongation strain of the bone segment and the mutual rotation of the bone fragments (see Fig. 4).

The proposed method allows to predict the plan of the rehabilitation process, based on the spatial model of deformed limbs each Conques and, which leads to the reduction of treatment time.

In addition, allows us to predict the spatial model deformed bones before and after the correction, which allows for timely control of performing osteosynthesis. The spatial model of the bones of the limbs and segments it is possible to depict on the display or on paper.

The proposed method is carried out using a personal computer and used in the clinical Department of the deformation of RISC"RTO".

A method for predicting the optimal correction of the deformity of the limb, including the construction of models of deformed limbs and extremities are normal, their comparison and compilation of the mathematical algorithm used to predict the correction of limb, characterized in that the construction of the models is carried out in the form of spatial images and calculations for mathematical and plotting perform on the basis of the averaged standard deviation of the axis of the deformed segment and/or limbs from the correct biomechanical and anatomical axes.

 

Same patents:

The invention relates to medicine, namely to traumatology, orthopedics and neurology, and can be used for the treatment of patients with diseases of the vertebrae, intervertebral joints and discs of the lumbar spine

The invention relates to medicine, in particular, trauma in the treatment of patients with dislocation of the acromial end of the clavicle and clavicle breaks-acromiale ligament
The invention relates to medicine and can be used in traumatology and orthopedics, in particular, for the treatment of static instability of the knee joint

The invention relates to medicine, specifically to methods of plastic surgery
The invention relates to medicine and is intended for the treatment of patients with synovitis

The invention relates to medicine, namely to orthopedics and traumatology

The invention relates to medicine, namely to traumatology and can be used for osteosynthesis of injuries of the anterior and posterior pelvis

The invention relates to medicine, in particular for orthopedics and can be used in the surgical treatment of ploskovice of talipes

The invention relates to medicine, namely to orthopedics and traumatology

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should isolate and dissect the tendons of anterior tibial and long fibular muscles to dissect the tendon of posterior tibial muscle against the site of fixation and direct it towards plantar rear area in front of internal ankle through the tunnel in subcutaneous fiber, then one should subcutaneously direct dissected tendons of anterior tibial and long fibular muscles onto plantar rear area to suture them so to leave free the tendinous end of posterior tibial muscle which should be intraosseously fixed to median wedge bone that keeps the process of foot repulsion during walking.

EFFECT: higher efficiency of therapy.

5 dwg, 1 ex

FIELD: medicine, traumatology, orthopedics.

SUBSTANCE: one should perform reposition of talus fragments followed by resection of articular surfaces of talus and calcaneus by maximally restoring anatomy of tarsal plantar department without forming any groove in talus and resecting wedge-like fragments with their wedge bottom towards the side being opposite to deformation. Then one should develop an autotransplant out of ileum's ala by taking into account the form of modulating resection at its length being from talus' posterior edge up to Chopart's joint without vascular pedicle. Autotransplant should be fixed due to applying Ilizarov's apparatus that enables to cure aseptic necrosis, pseudoarthroses, remove pathological foot's phenomena at shortened time for operative interference and narcosis, decreases traumaticity of operative interference at total decrease of therapy terms.

EFFECT: higher efficiency of therapy.

1 ex

FIELD: medicine, traumatology, orthopedics.

SUBSTANCE: one should perform incision along internal surface of talocrural joint, open internal ankle and distal tibial metaepiphysis, perform osteotomy of internal ankle, remove cartilages at articular surfaces of internal ankle and internal department of patient's talus, carry out fibular osteotomy being above incorrectly fused fracture, dissect distal fibular fragment outwards, perform osteotomy of incorrectly fused fracture of posterior tibial edge to be then repaired and osteosynthesized, remove cartilages from articular surfaces of fibula and tibia and talus, remove posterior-external subluxation of talus, conduct temporal transarticular fixation of talocrural joint with needles at correct position of talus, perform osteosynthesis of osseous fibular fragments after osteotomy fulfilled, fix external ankle with a screw to tibial and talus epiphysis, perform osteosynthesis of internal ankle, remove transarticularly introduced needles, fill talocrural fissure developed with osseous transplants developed out of anterior-external department of distal tibial metaepiphysis.

EFFECT: increased accuracy of reposition, improved conditions for fusion.

3 dwg

FIELD: medicine.

SUBSTANCE: method involves using wires as temporary fixing members. The wires are introduced reach the external cortical layer after setting the fracture for the period a permanent fixing member is under setting. The wires are removed from the opposite bone side with respect to the fixing member.

EFFECT: enhanced effectiveness in fixing and holding small-sized splinters; high reposition accuracy.

2 dwg

FIELD: medicine.

SUBSTANCE: method involves elongating arm biceps and brachial muscle in distal part. Brachioradial muscle is partially detached from the place of its attachment to achieve full forearm extension.

EFFECT: complete repair of mobility in articulation.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves carrying out reduction and fixation of fractured bone fragments. At least two adjustable length rods are used. The rods have end heads and openings for making attachment to mandible. One of the heads is freely rotatable relative to the rod and the other one is movable along longitudinal rod axis. Reduction and fixation is made in positioned centric jaw relation. The rods are set between the mandible and maxilla to the right and left of the center at the level of failed second incisor and second bicuspid teeth.

EFFECT: reduced risk of traumatic complications; reduced periosteum detachment.

3 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: method involves producing and transplanting and implantable segment containing mature cartilage tissue cells fixed on absorbable supporting matrix for repairing animal cartilage. The implantable segment has absorbable elastic supporting matrix for culturing and fixing living cells thereon. Instrument for introducing the implantable segment, having mature cartilage tissue cells on supporting matrix, into defective animal cartilage area, has clamps and external tubular envelope. The envelope has an end holdable by user and an end for making introduction into defective cartilage area. Holder and telescopic member are available in the envelope end holdable by user. Injection canal is partially embedded into the holder and projects beyond the holdable envelope end towards the end for making introduction. The clamps are attached to the telescopic member. They are well adapted for catching and releasing the implantable segment when telescopically moving the holder in the envelope.

EFFECT: enhanced effectiveness in arranging and fixing implantable segment in the implantation place.

47 cl, 11 dwg

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should perform reposition of osseous fragments at simultaneous reinforcing their thickness with porous titanium nickelide implants. Then one should perform osseous fixation of apophysotendinous stump with titanium nickelide clips at shape memory effect. In particular case, reinforcing should be fulfilled due to implanting elastic porous titanium nickelide plate. In paticular case, reinforcing could be performed due to implanting finely granulated porous titanium nickelide at granules size being 0.1-2 mm. In particular case, reinforcing should be carried out due to implanting elastic porous titanium nickelide plate and finely granulated porous titanium nickelide at granules size being 0.1-2 mm.

EFFECT: higher efficiency of fixation, decreased traumaticity.

3 cl, 2 dwg, 1 ex

FIELD: medicine, traumatology, orthopedics.

SUBSTANCE: in case of the suggested method of treating one should isolate extensor's tendon damaged in area of nail phalanx to suture it with a certain suture, the ends of ligature should be directed through oblique canal in nail phalanx to withdraw through the skin and fix them on S-likely curved free end of a needle that fixes the nail phalanx. In case of the present method of therapy it is possible to exclude the pressure upon soft tissues of volar surface of nail phalanx to prevent the development of scar-resulting bedsore and disorder of palpable sensitivity of patient's finger.

EFFECT: higher efficiency of therapy.

1 cl, 2 dwg

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should form a transplant out of femoral biceps' tendon, form an oblique-cross-sectional transfemoral canal in isometric area upon external femoral condyle, right to the front against insertion fibular collateral ligament, apply proximal end of crossed femoral biceps' tendon through this canal, fix the end of crossed femoral biceps' tendon upon internal femoral condyle. The method enables to prevent tendinous rupture at the site of its new fixation and avoid the loss of articular bending function.

EFFECT: higher efficiency of therapy.

2 dwg, 1 ex

Up!