Method for exarticulating hip joint from human cadaver

FIELD: medicine.

SUBSTANCE: method involves making incision in skin, subcutaneous cellular tissue and proper fascia beginning from anterosuperior iliac spine along the anterior femur surface to the level being 3-5 cm below the lesser trochanter. Bones are bypassed for cutting them with Gigli saw with a conductor manufactured as S-shaped rigid tube having one end sharpened and attached to one of Gigli saw ends with its other end. The conductor and Gigli saw end is brought through muscular lacuna for cutting iliac bone and brought out through suprapiriform opening. The conductor and Gigli saw end is brought for cutting ischial bone body through obturator foramen and brought out into operation wound. The conductor and Gigli saw end is brought for cutting pubic bone body through obturator foramen and brought out into operation wound. The conductor and Gigli saw end is brought for cutting femur bone body from medial side of the femur below the lesser trochanter level.

EFFECT: reduced risk of injuries in articulation and periarticular tissues; reduced losses of cadaver material.

2 cl

 

The invention relates to medicine, namely to experimental surgery, can be used to analyze the structure, topography and development interventions at the hip joint and its components.

The development of operative surgery is closely associated with the development and improvement of methods and techniques of anatomical studies. Due to the fact that the study of the topographic anatomy any area of the human body plays a big role definition of the relationship of anatomical structures within this particular area, a method commonly used layer-by-layer anatomical dissection. This is of particular importance for surgical practice, since the cuts are carried out with consideration of the individual layers.

For preparation and development of tactics surgical interventions are unopened and opened whole corpses or its individual organs and body parts. With the aim of extracting separate parts of the body previously produces the dismemberment of the human body. In modern literature there are works devoted to study of sectional complexes hip joints: Vaskis HA Hip and operations on it. M: Medicine. - 1966. - p.140; Malakhov O.A., Morozov A.K., Ogarev E.V., Kosovo I.A. the Development of the hip joint in children and is podrostkov (experimental anatomical and radiological study). // The Bulletin of traumatology and orthopedics. - 2002. No. 3. - p.70-75; Spirov MS Guide to dissection of the muscles, ligaments and nerves of the person. M: Medgiz. - 1954. - pp.272; Tikhonenkov Y.S. Residual subluxation of the hip in children and their surgical treatment: Dissertation Dr. med. Sciences. - L., 1981; chatzilla I., Ariel BM Anatomical and functional features of the hip joint. // Morphology. - 1996. - T. No. 6.-s.112-115.

Closest to the claimed invention is a method of extraction of the hip joint (chatzilla I., Ariel BM Anatomical and functional features of the hip joint. // Morphology. - 1996. - T. No. 6. - s.112-115), which consists in the following. After the implementation of the access Smith-Petersen in the modification of p. g Korneva, without opening the capsule of the hip joint and without damaging the ligaments, wire saw, Gigli in a horizontal plane across the body of the Ilium proximal to the joint space. Then produce the intersection of the symphysis. When expressed pathological mobility of the lower limbs with crepitation at the level of the pelvis perform perepilivanija of the femur at the junction of the upper and middle thirds. After clipping the soft tissues of the hip joint are removed by block.

Skin incision peregrinating online access to the hip joint by Smith-Petersen in modificat and p. g Korneva start from the middle of the iliac crest and ends at 7-10 cm below the greater trochanter.

It should be noted that in recent times there is a lack of cadaveric material in morphological laboratories, so research is necessary to use cadaveric material sparingly and with the greatest possible benefit. All of the above methods, including the most intimate way, do not allow this, because they use damaged a large area of bone and muscle of the material of the corpse.

The claimed invention solves the problem of creating a method of sampling sectional complex hip joint with minimal damage to surrounding tissues.

This task is solved in that during the execution of the method disarticulation of the hip joint of the human body, which perform the incision of the skin, subcutaneous tissue and the fascia own hip joint, cross located in the region of the hip joint body of the Ilium, the body of the femur using a saw Gigli and extract the separated joint, the incision is performed, starting from the level of the front-upper spine of the Ilium on the front of the thigh to below the lesser trochanter to 3-5 cm, optional cross body upper pubis, ischial bones, and for crossing bodies of bones round the body of each bone saw j is Li with use Windows Explorer, representing an S-shaped rigid tube, inside of which set the rod pointed at one end, the other end of which is connected to one end of the saw Gigli, and the conductor is performed to rounding of the Ilium through the muscular lacuna and out through aggressivenes hole, tel ischial bone and the upper branch of the pubic bone - consistently through the locking hole, the body of the femur - medial side of the femur below the level of the lesser trochanter.

This separation of muscle tissue can be performed using the tool, the working of which is a double-edged blade, the end of which is bent at an angle 120-145°.

Authors and applicants are not known from existing literature sources this way, we can therefore conclude that the technical solutions according to the criterion of "novelty", and distinctive features can be attributed to the differences, as these features is unknown.

The method is as follows. Access to the hip joint are cut by Guturu. The proximal end of the incision starts from the level of predavanja spine of the Ilium or more medially from her and crosses the line going from the base of the greater trochanter to the pubic tubercle, which is projected femoral neck KOs is I. Incision surgical access is obliquely on the anterior surface of the upper third of the thigh to below the lesser trochanter on 3-5 see

Cut through the skin, subcutaneous tissue and superficial fascia. After dissection of the fascia own tailor's muscle pulling outwards. The femoral vessels are isolated and pushed medially. The deep artery and vein of the thigh impose double ligatures and cross between the ligatures.

Perepilivanija bones of the pelvis and femur produce a wire saw Gigli scheme. For holding the end of a wire saw Gigli through a greater thickness of the soft tissue behind the bone conducting conductor, which is an S-shaped stainless steel tube with a diameter of 5.0 mm, inside which is located the rod pointed at one end, the other end of which is fixed on one end of the wire saw Gigli. The rod can be made of stainless steel with a diameter of 1.0 mm

Initially producing perepilivanija ischial bone, this conductor passes through the locking hole. After immersing the conductor in the desired direction and the plane by pushing the pointed end of a metal rod pierce the soft tissue, and it is held in the operative wound. Then dragged through conductor is connected to the rod end of the wire saw Gigli. The end Provolone the th saws off the hook rod guide, remove the conductor on both loops of wire saws don holders and perepilivat bone.

Guide for sawing the upper branch of the pubic bone is performed in the same manner through the locking hole.

For sawing iliac bone conductor to carry through the muscular lacuna and out through aggressivenes hole.

Thigh perepilivat slightly below the level of the lesser trochanter conducting saw Gigli with the medial side of the femur below the level of the lesser trochanter.

After crossing the bones of complex hip seize bone hooks and separated from soft tissues. Muscles and fascia on the posterior hip joint dissect the amputation knife, the working of which is a double-edged blade, the end of which is bent at an angle of 120 -145°. The bend angle is selected experimentally, on the basis of ease of use of the tool and the effectiveness of the Department of soft tissue

Surgical wound is sutured in layers. Own fascia sew a continuous blanket stitch skin and impose furrier seam.

Thus, the inventive method facilitates the technique of taking a breakout complex hip joint without damage to the components of the joint with minimal damage to the periarticular tissues.

The proposed namespaces and technical devices tested in the capture section complex hip joint 10 fresh cadavers with a positive result.

1. The method of extracting the hip joint of the human body, including the skin incision, the subcutaneous tissue and the fascia own in the hip joint region, the intersection is located in the hip area of the body of the Ilium and body of the femur using a saw Gigli, removing the separated joint, characterized in that perform incision, starting from the level of the front-upper spine of the Ilium on the front of the thigh to below the lesser trochanter to 3-5 cm, optional cross body ischial bone and the upper branch of the pubic bone, cross bones round their saw Gigli using Windows Explorer, representing an S-shaped hard tube inside of which is mounted a rod, pointed at one end and the other end attached to one end of the saw Gigli, the conductor with end saw Gigli for crossing the Ilium is carried out through the muscular lacuna and out through aggressivenes hole, cross body ischial bone conducting conductor with end saw Gigli through the locking hole and taken to the operating wound, then to cross the upper branch of the pubic bone conducting conductor with end saw Gigli through the locking hole and taken to the operating wound for crossing the body of the femur conducting the conductor with the end of the saw Gigli with the medial side of the femur below the level of the lesser trochanter.

2. The method according to claim 1, characterized in that the separation of the muscle tissue is made with the help of the tool, the working of which is a double-edged blade, the end of which is bent at an angle 120-145°.



 

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