Method for wrist reconstruction in children in case of aftereffects of trauma |
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IPC classes for russian patent Method for wrist reconstruction in children in case of aftereffects of trauma (RU 2250084):
          
 Method for making bone defect plastic repair / 2249438
Method involves setting axial biocompatible polymer pin half-split to its middle. Its whole portion is distally immersed into medullary canal, and conically sharp split end is introduced into proximal bone metaphysis. Residual space is substituted with flexible biocompatible polymer rods in straw mode.
 Method for treating the cases of knee joint cruciform ligament abruption / 2249437
Method involves forming intraosseous canals in femoral and tibial condyles. An implant (synthetic in particular cases) is brought through the canals. Free implant ends are fixed near canal outlet openings. Retained portion of long anterior cruciform ligament stump is separated from posterior cruciform ligament all over its length.
 Method for creating bone fragments intercompression in treating tibia fracture cases / 2249436
Method involves setting two opposite Kirschner wires with rest platform through fracture line in perpendicular to crus axis. Plaster splint is applied. The wires are attached to Ilisarov apparatus ring. The ring is fixed on the plaster splint by means of two or three cantilever attachment members. The cantilever attachment members have brackets, short threaded rods, nuts, metal plates having openings for receiving a threaded rod, stepped bend giving space for setting internal nut. Metal plates allow shaping their surface to match contact surface relief. The metal plates thrust against plaster splint surface by turning the screws on brackets. Plate is additionally plastered with plaster bandage turns allover its length with the exception of middle part step.
Method for treating lateral sacral fracture / 2248765
One should introduce a compressing screw through patient's ilium, sacroiliac articulation into the sacrum being cross-sectionally against the fracture line. The cap of compressing screw should be applied with support directly onto the sacrum through pre-developed channel in the ilium. The method enables to prevent the development of deforming arthrosis and save compressing efforts for the fracture.
 Method for treating fractures of femoral proximal department at detachment of caput femoris lesser trochanter in case of coxarthrosis / 2248764
One should conduct reposition of fragments on orthopedic table by performing valgusation of femoral proximal fragment. Then one should apply the apparatus of external fixation: one of its rods should be introduced directly into detached lesser trochanter. Then, 7-14 later, one should start to replace it by dosages in time directly into ischial bone. The method enables to create anatomically profitable valgus position of caput femoris followed by fixation of trochanterian fragments, carry out caput femoris unloading and provide earlier activation in patients of older age group.
Method for treating flexo-rotational contracture of hip joint in patients with juvenile cerebral palsy / 2248763
Anterior portion of middle gluteal muscle should be distally dissected against greater trochanter by developing proximal stump, patient's thigh should be unbound to be further rotated outwards within the angle of 10 deg., and in this position it should be sutured with developed distal long muscular stump straining the broad femoral fascia after its dissection against anterior upper spine of ilium that forms new direction of gluteal muscle's action in removing the contracture.
Method for treating shifted fractures of cotyloid cavity / 2248762
By applying an apparatus of external fixation one should remove the protrusion of caput femoris, perform open reposition of cotyloid cavitary fragments by fixing with a plate, moreover, its one end should be placed into small pelvis, and another one should be fixed with screws towards internal surface of ilium being above patient's innominate line to provide rigid fixation and prevent protrusion relapse.
Method for treating fractures of tibial posterior edge / 2246915
One should perform foot's traction along shin's axis, shift patient's foot to the front to provide the position of plantar bending till relaxation of calcaneal tendon, shift it towards inside with sagittally applied fingers against a shin and affect the fracture from the top and from the rear to the front, then a foot should be transferred into unbending position.
Method for osseous-plastic arthrodesis of talocrural joint / 2246914
At surgical treatment of deforming arthrosis of patient's talocrural joint with oscillating saw out of anterior access in sagittal plane one should cut transplants for the whole thickness of tibia and talus. Moreover, a tibial transplant should be formed of higher length against that of talus. One should remove articular cartilage at transplants. Talotransplant should be removed out of the wound to replace tibial transplant to its place by not losing its connection with periosteum and soft tissues along posterior surface. One should wedge in a talotransplant into the tibial defect developed. The method enables to increase the area of adjoining surfaces and save transplant's supply.
 Method for removing thumb's adducting contracture / 2246913
The present innovation deals with treating aftereffects of wrist's defects. One should cross muscular tendon of thumb's short extensor at the border with muscular part. Tendon of long thumb-abducting muscle should be resected for 5-6 cm being proximally against fixation level. One should conduct tenodesis in position of thumb's contrasting, suture up the distal tendinous end of long thumb-abducting muscle to tendon of wrist's radial extensor. Distal tendinous end of thumb's short extensor should be applied through carpal canal to be sutured with proximal tendinous end of long thumb-abducting muscle. The present method enables to increase grasping function, thumb's stability in opposition position and decrease traumaticity.
 Method for surgical treatment of foot-drop at fibular nerve paralysis / 2243735
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.
Method for treating post-traumatic talus diseases / 2243736
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.
 Method for talocrural arthrodesis at incorrectly fused fibular fractures and those of posterior tibial edges / 2243737
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.
 Method for treating comminuted fractures / 2243738
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.
 Method for treating children suffering from juvenile rheumatoid arthritis for elbow joint flexion contracture / 2243739
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.
 Method for treating the cases of edentulous mandible fracture / 2243740
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.
 Methods, instruments and materials for transplanting cartilage tissue cells / 2244521
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.
 Method for surgical treatment of perosseous tendinous ruptures of brachial rotator muscles / 2244522
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.
 Method for treating finger extensor's tendinous lesion in area of fixation to nail phalanx / 2245682
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.
 Method for treating posterior-external rotation instability of knee joint / 2245683
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.
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FIELD: medicine, surgery. SUBSTANCE: the present innovation deals with dissecting coarse post-traumatic scars followed by descending a traumatized radius distally and substituting the defect developed with an autotransplant consisted of radial fragment of patient's antebrachium and patient's radius fragment upon total vascular pedicle. The method suggested enables to improve both functional and cosmetic state of patient's wrist and shorten terms of therapy. EFFECT: higher efficiency of wrist reconstruction. 6 dwg
The invention relates to medicine, namely to orthopedics and traumatology, and can be used when the consequences of a firearm or explosive wounds brush. With this type of injury, if you are able to save the brush, the more often it is disfigured by scars and deformations preserved fingers, and its function is significantly reduced. The known method of reconstruction brush with trauma, consisting of several plastic surgery carried out for a long time (months, years), such as plastic surgery of the skin; bone grafting; tendon plastic. Using bone ALLO - and autografts was measured (Aiellos. Plastic, reconstructive and aesthetic surgery. - Saint-Petersburg. "Hippocrates". - 1998). The disadvantage of this method is a lot of stages of surgical treatment and, therefore, the high duration of the course restore the function of the brush, and thus there is a long rebuilding bone graft and possible partial or complete resorption. The objective of the invention is to improve functional and cosmetic condition of the brush and reduction of treatment time. therapeutic effect of the task is achieved in that in the method of reconstruction of the brush (e.g., 4-Palaia), damaged by a gunshot wound, for lucases in gross excision of scar tissue, offered with simultaneous excision of post-traumatic scarring, causing flexion contracture and ulnar deviation of the surviving rays brushes, to carry out the reduction of the injured beam in the distal direction, the substitution of the resulting defect krovosnabjaemah autograft, consisting of the radial forearm flap and radial bone fragment on total vascular pedicle dimensions corresponding to the defect. Figure 1 presents the scheme of the brush sick W., 12 years with a diagnosis of post-traumatic deformity of the right hand after the formation of the wound defect, item 1 - the remainder of the 4th metacarpal bone; 2 - soft tissue and bone defect formed after excision of the scar tissue. Figure 2 - scheme of the brush (at the end of reconstructive surgery) patient W., 12 years with a diagnosis of post-traumatic deformity of the right hand, item 1 - the remainder of the 4th metacarpal bone; 2 - transplanted radial forearm flap with a fragment of the radial bone in the total vascular pedicle; 3 - the donor area. The method of reconstruction of the four-toed stroke consequence of gunshot wounds is as follows. On the ulnar surface of the brush excising the scar tissue is allocated preserved distal fragment of the 4th metacarpal bone, which is freed from scars and together with the 4th finger is reduced in estaljnom direction so to the 4th metacarpal-phalangeal joint was located at the same level with the third. Measure the length of the bone defect and removed the pattern shape and size of the wound defect, which should be close full skin. Then measure the required length of the vascular pedicles of the planned flap, which will start from the Palmar radial surface of the forearm in the projection of the wrist joint. From this zone on the forearm in the proximal direction is a linear incision, which is in the middle third ends with the formation of a skin flap harvested the pattern. The length of the linear section corresponds to the length of the vascular pedicles of the forearm in the proximal direction along the projection of the radial artery, where and cut out skin and fascial radial flap, which includes the necessary size of the bone fragment from the radial diaphysis of the bone. Last thickness equal to the radius of the radial bone and krovosnabzhayutsya branches of the radial artery, which Perevoznaya proximal allocated flap and overlaps. Then perform the selection of the radial artery and the accompanying her veins in the distal direction until the projection of the wrist joint, with coagulated and cut off all the side of the arterial and venous branches. Not cutting off the distal vascular N. the HCS, the graft is separated from the donor bed and moved into the subcutaneous channel on the ulnar surface of the hand. A fragment of the radial bone is placed in the position of the 4th metacarpal bone is fixed longitudinally and transversely carried by the spokes. The skin portion of the graft is fixed with sutures to the recipient bed. The wound defect on the forearm skin is replaced with a thick split graft, taken from the lateral surface of the right thigh. Superimposed aseptic bandage. The extremity is fixed in a plaster splint for 4 weeks prior to the consolidation of the bone fragments. An example of executing. Patient W., 12 years with a diagnosis of post-Traumatic deformity of the right hand (the consequence of a gunshot wound). Brush - Cuatro dedos (5th finger amputated at the time of injury), the 4th finger is shortened due to damage to the metacarpal bones (Fig 3, item 1), is a flexion contracture, and ulnar deviation, flexion contracture of the 3rd finger, rough tightening scars on the ulnar surface of the brush (figure 3, item 2). Marked limitation of movement in the joints of the 3rd finger and the lack thereof in the joint of the 4th finger. Radiograph shows the preservation of the distal epiphysis of the 4th metacarpal bone (Fig 3, 3). The remaining bones are preserved rays is not damaged. The child produced following surgery. Thirty days after surgery removed the spokes. Plaster bandage is removed after one week. A course of rehabilitation treatment. Received a good functional and cosmetic result (6). The method of reconstruction of the brush in children with trauma, involves excision of the rough scar tissue, characterized in that simultaneously with gross excision of post-traumatic scars are taking the injured beam in the distal direction, the substitution of the resulting defect with autograft, consisting of the radial forearm flap and radial bone fragment on total vascular pedicle dimensions corresponding to the defect.
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