Method for fixing revascularized osseous autotransplant for treating defect-pseudoarthroses of long tubular bones |
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IPC classes for russian patent Method for fixing revascularized osseous autotransplant for treating defect-pseudoarthroses of long tubular bones (RU 2250085):
     
 Method for wrist reconstruction in children in case of aftereffects of trauma / 2250084
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.
 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 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, traumatology, orthopedics. SUBSTANCE: before applying autotransplant into defect area the bone should be treated. For this purpose one should dissect its atrophic end to form a longitudinal channel there. Then one should rotate the treated osseous fragment for 180є to be introduced into medullary canal of the bone. Osseous revascularized autotransplant should be placed into defect area, then one should apply axial compressing needle to fix it at one of these osseous fragments. Another osseous fragment should be supplemented with the apparatus for external fixation where one should pull intramedullarly applied needle. On stabilizing the fragments and the transplant one should perform microsurgical stage of operation by suturing arteries and veins. The method suggested improves conditions for the increment of revascularized osseous autotransplant due to developing a stable edge support between the transplant and osseous fragments. EFFECT: higher efficiency of fixation. 3 dwg
The invention relates to medicine, namely to traumatology and orthopedics, and is intended to ensure defect-pseudoarthrosis long tubular bones. When treating a defect-pseudoarthrosis long tubular bones using revascularisations bone autograft from the fibula (Belousov A.E., 1988; Golubev V.G., 1985; Holowchak BJ, 1993; Grishin, I.G. et al., 1994, 1996, 2001). There is a method of fixing a bone graft by Ilizarov (Shevtsov V.I., V.D. Makushin, Kutyrev L.M. Pseudoarthrosis, defects of the long bones of the upper limb and contracture of the elbow joint /basic technologies of treatment by Ilizarov/. - Barrow: the Urals, 2001. - S). Through the bone graft spend two pairs of crossed spokes. This can lead to severe disorders of blood supply to the bone tissue, which negatively affects reparative regeneration in the connection zone of the bone and graft, increasing the period of consolidation in 2-3 times (Onoprienko G.A., 1984, 1993). Known method combined a busy osteosynthesis (Barabash A.P., Solomin L.N. Combined stressful osteosynthesis. - Blagoveshchensk, 1992. - p.20), in which the axial compressicauda spoke conduct intramedular through the bone fragments and autograft. One of the ends of the spokes fixed plate and unsustaina, and the other end with justices who jemym force pull in an external device. The disadvantage of this method is the difficulty of creating a sustainable end stop between the bone fragments and autograft in cases of pronounced differences in the diameter of the diseased bone and graft. To eliminate telescopic implementation of the graft in the bone-marrow channel of the fragments of the recipient bone graft is necessary to position the eccentric. This reduces the contact area between the graft and the ends of the bone fragments. Axial compressicauda needle held in the bone-marrow channel is offset from the Central axis of the bone. This leads to the fact that when the tension force occurs, contributing to secondary displacement of bone fragments, which worsens the conditions for the fusion of the graft with the bone fragments. There are methods and compounds free tube allograft with resected end of the bone of the patient, which suggests the formation of different stops, in the processing of bone bits or cutters (Zatsepin ST Safe surgery for bone tumors. - M.: Medicine, 1984, pp. 102), which is unacceptable when you commit revascularizing transplant because of a possible violation of its blood supply. The technical result of the invention is to improve conditions for increment revascularizing bone autotransplant is and by creating a sustainable end stop between the graft and bone fragments. This is achieved by the fact that the autograft in the area of the defect recipient bone handled. Cut it off, atrophic end and form therein a longitudinal channel (Figure 1). Deploy processed in a similar manner, the bone fragment 180 degrees and implement it into the bone marrow canal of the bone (Figure 2). A similar operation, if necessary, performs on the opposite part. Bone revascularisations autograft is placed in a region of the bone defect, spend axial compressicauda needle and fix it with thrust pad on one of the bone fragments. On the other bone fragment impose the external fixation device and pull it intramedular conducted spoke. When this occurs compressible force at the junction fragments with the graft (Figure 3). After stabilization of the fragments and transplant perform microsurgical phase of the operation, which is the seam of arteries and veins. The method of fixation revascularizing bone autograft for the treatment of defect-pseudoarthrosis long bones with intramedullary conduction through bone fragments and autograft spokes, fixing it on one bone fragment and tension in perosseous apparatus imposed on another bone fragment, characterized in that before you placed the eat autograft in the area of bone defect treated, why cut atrophic end of the bone fragment, to form therein a longitudinal channel, unfold the bone fragment 180 degrees and implement it into the bone marrow canal of the bone, bone revascularisations autograft is placed in the region of the defect.
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