How corticotomy tibia for lengthening

 

The invention relates to medicine, namely to traumatology and orthopedics. The essence of the proposed method is that of the internal incision of tibia in metatithemi subperiosteal region in the frontal plane cut through the back, front and inner cortical plate without damage to the bone marrow, the outer cortical plate cut Z-shape without detachment of the periosteum by the amount produced of skin incision, which provides osteocephalus. 3 Il.

The invention relates to medicine,namely to orthopedics, and concerns the methods of surgical treatment of diseases of musculoskeletal system, in particular, patients with LLD.

Known methods of dissection of the tibia for lengthening:

1. The Ilizarov Method (2).

The peculiarity of the method is to impose the Ilizarov apparatus. From the front arcuate cut a length of 5-6 cm subperiosteal produce transverse oval osteotomy of the anterior half of the tibia. The posterior half of the tibia cross in an oblique direction from the top to the back and down the back.

The disadvantage of this method is in the lengthening of the tibia with less regeneration.

2. The Way My Grandfather (1).

The essence of the method is to produce a Z-shaped osteotomy of the tibia in the area of the upper and middle thirds and oblique osteotomy of the fibula.

The disadvantage of this method is increased invasiveness due to the detachment of the periosteum and damage to the bone marrow over a large area that is causing the slowdown of reparative regeneration, therefore the described method podiatrists currently almost never used.

The prototype was taken way Grandfather.

The main disadvantage of the prototype is a big trauma.

The aim of the invention is to reduce the trauma.

This goal is achieved by the fact that cross the front, inner and posterior cortical plate in metatithemi area in the frontal plane subperiosteal without damage to the bone marrow, and the outer cortical plate cut Z-shape without detachment of the periosteum on the length of the bone cut.

The graphic image of Fig. 1 shows the first stage of the operation - cross-cut narrow chisel 3 cortical plate 1 of the tibia to the outer cortical plate 4 under the control of the protective spatula 2; Fig. 2 is a longitudinal Z-shaped splitting 5 outer kotikalapudi way.

The skin incision on the inner surface of the tibia in metafigure Department length 4-5 see Periosteum prepare the chin for 3 cm and the rear surface at the bone down protective blade for soft tissues. Narrow chisel cut through the back of the cortical plate to the outer cortical plate. Control is carried out by the apparatus of the EOP. Also cross the front of the cortical plate. The wound is sutured.

The second skin incision is made on the anterior surface of the tibia from the level of the transverse osteotomy down the length of 1.5-2 cm longer than the expected lengthening. The periosteum is dissected longitudinally. Outer cortical plate a thin sharp osteotome cut longitudinally on the size of the skin incision. At the bottom of the outer half of the cortical plate cut in the transverse direction. The wound is sutured. Impose the Ilizarov apparatus. Fibula cut in oblique projection.

The fundamental difference between the proposed method from the known is the small traumatic bone marrow and soft tissues during dissection of the tibia, and the use to improve reparative regeneration of bone tissue of the bone bridge between the fragments of the outer corticales brain, use split cortical plates for stimulation of reparative regeneration.

The proposed method with a positive effect performed in patient K. 15 years, admitted to the orthopedic Department of the hospital of traumatology and orthopedics Samara state medical University, February 10, 2002 with a diagnosis of:

Congenital shortening of right leg by 4.5 see February 11, the operation has been performed on the proposed method. 3 months after surgery between the fragments have a regenerate with pronounced signs of ossification.

The method can be recommended in practical medicine.

The sources of information.

1. I. A. Movshovich. Operative Orthopaedics. M., 1994, page 318.

2. I. A. Movshovich. Operative Orthopaedics. M., 1994, page 317.

Claims

How corticotomy tibia for lengthening, including dissection of the tibia, wherein the cross front, inner and posterior cortical plate in metatithemi area in the frontal plane subperiosteal without damage to the bone marrow, and the outer cortical plate cut Z-shape without detachment of the periosteum on the length of the skin incision.



 

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