A method of surgical treatment of a fracture of the patella

 

The invention relates to medicine, namely to traumatology. The tendon of the quadriceps femoris and own a bunch of patella impose overlapping seams of Cuneo Mylar threads. The ends of the filaments is carried out through two parallel bone tunnel of the patella and tied at the top and bottom poles, providing a dynamic autocompression fragments. The method allows to increase the effectiveness of the treatment. 3 Il.

The invention relates to medicine and relates to methods of surgical treatment of diseases and injuries of musculoskeletal system, in particular patients with fracture of the patella.

Known methods of treatment of fractures of the patella:

1. The Method Yet [1].

The feature of the method of cutting out a U-shaped flap of a private of the patellar tendon, the convergence of the fragments of the patella and fixing them cut the flap.

The disadvantages of the method: the weakening own the patellar tendon, insufficient strength of fixation of the fragments of the stitches on the periosteum and the fragments of the patella.

2. The Way Schulze [2].

The essence of the method is the convergence of fragments sow.

The disadvantage of this method is the injury of the extensor apparatus significantly reduces the strength of the tendon stretching of the quadriceps femoris and other parapatellar structures due to the injury and degenerative processes. In this regard, the strength of fixation of the sutures through the tissue may be insufficient.

3. Way S. N. Izmalkov [3].

The essence of the method is the formation along the axis of the patella in both fragments of two parallel bone tunnels through which spend Mylar thread in the form of a double loop. The ends of the thread stitch the tendon of the straight muscle of the thigh and connects together. The method provides dynamic compression of bone fragments.

This method is used for the prototype.

The disadvantage of the prototype is the low efficiency of treatment in cases where the distal fragment of the small size.

The aim of the invention is to increase the effectiveness of treatment in cases where the distal fragment of the small size.

This goal is achieved by the fact that impose overlapping seams of Cuneo, the ends of which are conducted through the bone tunnels and tied at the upper and lower pole of the patella.

The graphic image of Fig. 1 shows the suturing of Cuneo 1 on its own ligament of the patella 2 and S. 3 - conducting threads of the seams of the patella 6 in distal and proximal directions, and the tying thread at the upper and lower pole of the patella.

The method is performed as follows. Internal parapatellar the cut length up to 10 cm layers cut through the soft tissue, exposing the patella, patellar ligament and the tendon of the quadriceps femoris. On its own the patellar ligament and the tendon of the quadriceps femoris suture Cuneo Mylar threads. Fragments of the patella after removal of blood clots from the articular cavity map and hold the tongs. In which form two parallel tunnel in the longitudinal direction. The ends of the threads of the upper seam of Cuneo carried out in the distal direction, the bottom seam of Cuneo in the proximal direction. After matching bone fragments and restore congruence in patellofemoral mating thread knotted at the upper and lower pole of the patella. Continuity damaged parapatellar stretching restore interrupted sutures chromic catgut. The tying thread at the upper and lower pole of the patella creates an instantaneous compression ratio associated bone fragments. In the biome the thigh tightens the lower part to the upper portion, and the threads of the bottom seam of Cuneo, fastened at the upper pole of the patella, will hold the top part in place. Thus, a physiological compression of fragments caused by the reduction in quadriceps muscle of thigh. Stable, not declining over time the fixation of a fracture will reduce time of immobilization and recovery of limb function. The proposed method can be used in the removal of the patella from its ligaments. After the suturing wounds impose a plaster boot for 6 weeks.

The fundamental difference between the proposed method from the known is the imposition of intermittent welds, Cuneo the Dacron on the tendon of the quadriceps femoris and own a bunch of the knee, holding the threads of the seams through the vertical channels and the tying of the ends of the threads at the upper and lower pole of the patella, creating a dynamic compression of the fragments of the patella.

The advantage of the proposed method over the known is the following: improves the bonding strength of the fragments with dynamic autocompression. This is achieved by suturing Cuneo own patellar ligament and the tendon of the quadriceps femoris, holding coiab can be applied at any level of fracture of the patella and isolation from their own bundles.

The proposed method with a positive effect performed in a patient with a fracture of the patella.

Patient W., 63, was admitted to the clinic of traumatology and orthopedics Samara state medical University 20.03.2002, with a diagnosis of a bad fracture of the right patella. Since 2 months. 25.03.2002, the operation took place on the proposed method. The postoperative period was uneventful.

Plaster bandage is removed after 6 weeks. Conducted post-operative rehabilitation. The result is good.

The method can be recommended in practical medicine.

Sources of information:

1. Manual of Orthopaedics and traumatology. M., 1968, I. 3, page 678.

2. Manual of Orthopaedics and traumatology. M., 1968, I. 3, page 679.

3. RF patent №2018278, M. CL. And 61 In 17/56, 1994

Claims

The method of surgical treatment of fractures of the patella by forming in fragments of bone tunnels and overlapping seam, characterized in that, to increase the effectiveness of treatment suture Cuneo own patellar ligament and the tendon of the quadriceps femoris, hold the ends of the thread through the bone tunnels of the patella and hang them on the upper and lower poles of the patella.



 

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