The way plastics residual osteomyelitic cavity

 

(57) Abstract:

The invention relates to medicine, particularly surgery, traumatology. Essence: for plastics residual osteomyelitic cavity produce fence plastic material is autogenous bone “chip” of the perifocal region before trephination of the affected area of the bone, which provides the settling down of the graft.

The invention relates to medicine, in particular to surgery.

The known method plastics residual osteomyelitic cavity adjacent muscle (Akihito, N., Galeev, M. A., Takhautdinov C. G., Yudin, J. B. Osteomyelitis //M: - Medicine, 1986, S. 193) without dissection of the flap. Muscle dipped kemptville seams, trying to keep it all over evenly adjoined to the walls of the cavity and the seams did not violate its blood supply.

The disadvantage of this method is that it is a heterogeneous tissue, and therefore has a low degree of engraftment. Often is atrophy of the muscle flap, the application of this method is very limited in besmislenih areas did not contribute to the affected area of the bone.

Also there is a method plastics residual osteomyelitis is tin, D., Cancer A. C., Linnik S. A., Saldun, P., Kravtsov, I. A., I. Agafonov A., Fakhrutdinov R. H., Haimin centuries Surgical treatment of osteomyelitis. - SPb.: Russian graphics, 2000, S. 200-202), which is taken as a prototype. The method is that is the harvesting of bone grafts from the iliac crest in the form of bone “gravel” and monolithic bone tranplantation, and then produce surgical treatment focus osteomyelitis and fill the bone cavity bone grafts with “hammering” monolithic grafts and wound closure.

The disadvantage of this method is high invasiveness and complexity in compact execution cavity, the violation of revascularization monolithic grafts that can lead to nepriryvnosti grafts and relapse.

Objective of the claimed invention is to improve the results of surgical treatment of patients with chronic osteomyelitis.

This task is solved by the fact that according to the way plastics residual osteomyelitic cavity, including the fence of a plastic material and the filling of the residual osteomyelitic cavity with subsequent wound closure, as the plastic material is ularization bone grafts.

The advantages of the inventive method lies in the fact that the use of homogeneous tissue contributes to the strengthening of the affected area of the bone. The method is applicable at all sites chronic osteomyelitis, minimally traumatic to the surrounding soft tissue, use direct access, domaintest operations, a high degree of engraftment (contact areas with high proliferative properties). In addition, it contributes to the restoration of a closed circulation in the hearth.

Declared implement the method as follows.

Use direct surgical access, gentle and narrow detachment of the periosteum. Fence plastic material - free autogenous bone “chips” made from perifocal region before trephination of the affected area of the bone. The post-traumatic osteomyelitis in morphology is accompanied by necrosis of the cortical plate (octet) - it is subject to the initial removal, these fabrics for plastics are not used. Based on data from intraoperative macroscopic picture of the bones and x-ray diagnostic methods produced the harvesting of autologous bone “chip” bit from the third layer (zone osteocare oswaldoi curl in the direction of the cross section of the bone. “Chips” is collected in a sterile vessel with water of 0.02% solution of chlorhexidine digluconate. The total amount of “chips” should be slightly more volume osteomyelitic cavity (because we have to necrsequestrectomy). Then performed a radical necrsequestrectomy. Residual bone cavity filled bone “chips”, giving the latter the size of ~ 8×12 mm, to the level of the surrounding bone. These dimensions allow, on the one hand, sufficiently compact to perform residual bone cavity, also create conditions for the revascularization of bone graft ("chip"). The finishing operation required by the matching edges of the periosteum with carefully layered wound closure.

Example 1.

Patient K., aged 65. Diagnosis: Chronic post-traumatic osteomyelitis, right tibia, aggravation. Operation: Necrectomy, sanitation, plastic bone “chips” from the perifocal region. The postoperative period was uneventful. At discharge and after 3 months x-ray control was, at the last signs of the formation of callus. Spent 29 of bed-days.

Example 2.

Patient D., aged 35. Diagnosis: Chronic hematol the “chips” of the perifocal region. The postoperative period was uneventful. At discharge, and after 2.5 months x-ray control was, at the last signs of the formation of callus. Spent 22 bed-day.

The way plastics residual osteomyelitic cavity, comprising filling a bone cavity bone autostroke with subsequent wound closure, characterized in that the bone chips produced from perifocal region before trephination of the affected area of bone.



 

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