Method for exarticulating hip joint from human cadaver
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.
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°.
FIELD: medicine, experimental surgery, possible use for making models of surgical illnesses.
SUBSTANCE: to reproduce mechanical impassability of gall or pancreatic animal ducts in chronic experiment, mechanical obstruction is formed on the way of draining of digestive juice with possible later restoration of its influx into bowels. To form mechanical obstruction, elastic inflatable vessel is mounted in bowel gap oppositely to mouth of duct, closing bowel gap. Bowel tube in place of vessel position is reinforced by sewing around it with non-absorbable threads.
EFFECT: possible reproduction of mechanical impassability of digestive gland ducts of animals without need for repeated operations, without using operations on ducts.
FIELD: medicine, experimental surgery, possible use for forming temporarily isolated bowel loop in medical-biological research.
SUBSTANCE: one leather sleeve is made. Proximal and distal portions of isolated bowel loop are encased therein. Onto serous-muscular edges of apertures in abdominal wall between abdominal cavity and leather sleeve sutures are applied, expanding laparotomy incision. In another case muscular edges of apertures in abdominal wall are driven apart by means of rigid, for example, metallic arc. Given number of fistula tubes is applied onto temporarily isolated bowel loop. Artificial way for moving chyme from proximal to distal sections of main portion of bowels is formed.
EFFECT: reduced trauma level of invasion.
3 cl, 7 dwg
FIELD: medicine, experimental cardiopharmacology.
SUBSTANCE: in an experiment one should intragastrically introduce APP inhibitor analapryl for laboratory animal at endothelial dysfunction, at the background of its modeling, at the dosage of 0.5 mg/kg and intraperitoneally - L-arginine at the dosage of 200 mg/kg once daily. This enables to activate correction of endothelial dysfunction due to enhancing enzymatic NO formation, L-carnitine being its donator.
EFFECT: higher efficiency of correction.
1 ex, 2 tbl
FIELD: experimental medicine, in particular simultaneous modeling of chronic pancreatitis and hepatitis.
SUBSTANCE: claimed method includes application of mixture containing polychlorinated biphenyls in form of 5 % solution in olive oil. Said solution is administered into stomach in dose of 0.12 ml/100 g of animal mass 1 time per day every day for 12 days.
EFFECT: method for simultaneous reproducing of chronic pancreatitis and hepatitis in animals.
1 ex, 6 dwg
SUBSTANCE: method involves modeling cystic process by introducing 0.1% Synestrol solution in oil once a week during 35 days and exposing mammary gland to helium-neon laser radiation with wavelength of 633 nm and light guide exit power of 13 mW within 10 min during 8 weeks.
EFFECT: enhanced effectiveness in correcting and treating cystic processes in experimental animal mammary gland.
FIELD: experimental medicine and oncology.
SUBSTANCE: claimed method includes intraperitoneum cyclophosphan administration in dose of 120 mg/kg and intravenous transplantation of fetal liver steam cells to experimental animal. Fetal liver steam cells are transplanted for 3 days before cyclophosphan administration in dose of 25x106 cells/kg of mass.
EFFECT: decreased tumor growth, reduced frequency and area of metastasis due to optimization of cyclophosphan and steam cells administration.
FIELD: medicine, anatomy or descriptive medicinal educational guide-books.
SUBSTANCE: one should apply the suggested innovation in preparing educational vascular preparations at Departments of normal and topographic anatomy. One should pour filling mass into vessels. Moreover, the basis of filling mass is 100%-silicone dissolved with benzine at addition of oil-based paints - red cadmium and chromium-cobalt for arterial introduction, Berlin blue or Prague blue for veins, and green for biliary ducts. Moreover, at first, one should fill vessels of limbs, head and neck, then - other vessels, finally, they should be stained externally with the same filling mass. For this purpose one should additionally dilute filling mass with benzine at 1:3 ratio. The method provides availability of filling mass and quality of vascular filling at simultaneous internal and external vascular staining, simplifies procedures, shortens terms for preparing the suggested preparation at keeping natural appearance, shape and elasticity of vessels.
EFFECT: higher efficiency.
1 cl, 1 ex
FIELD: experimental medicine, oncology, dermatooncology.
SUBSTANCE: one should apply chemical carcinogen onto shaven part of rat's skin - 0.1%-7,12-dimethylbenz(a)anthracene (DMBA) as drops at the volume of about 35-49 mcl at 48-72-h-long interval between applications for 10-12 mo. This provides availability of rare basalioma's type as metatypical cancer in 99% rats at the terms of 42-48 wk.
EFFECT: higher efficiency.
FIELD: experimental medicine, biology.
SUBSTANCE: the present innovation deals with modeling experimental amyloidosis in animals with the purpose to obtain the chance for studying pathogenesis, prophylaxis and therapy. So, one should subcutaneously inject native egg albumin for animals every other day per 1 ml for 30 d. The innovation provides increased possibilities for modeling experimental amyloidosis at predominant splenic, hepatic and renal lesions for studying their functional state and circulation system, mineral exchange and other parameters associated with sodium impact and its detection.
EFFECT: higher efficiency of modeling.
1 ex, 1 tbl
SUBSTANCE: method involves para-articularly introducing adrenaline to rat ill in age-specific osteoporosis and renal osteodystrophy every day. 0.2 ml of 0.1% adrenalin solution is introduced during 6 weeks and 0.12 mg of methyl prednisolone is intra-articularly introduced twice a week under patella.
EFFECT: high reproducibility of focal bone necrosis model.
6 dwg, 1 tbl
SUBSTANCE: method involves fixing knee joint by applying orthopedic apparatus to injured extremity. The apparatus has hinges with supporting plates preliminarily bent outwards stage-by-stage at an angle exceeding frontal deformity of the knee joint by 3-5°, during the treatment course. Orthopedic insole is additionally used for setting crural axis by redistributing axial load applied to the internal foot part.
EFFECT: enhanced effectiveness of treatment; wide range of functional capability; alleviated pain syndrome manifestations; reduced drug load; prevented knee joint deformity and dystrophic process progress.
SUBSTANCE: method involves completing Z-shaped elongating achilloplasty with oblique transverse myotomy applied to lateral gastrocnemius muscle head and, when excessive muscle rigidity being the case, to medial gastrocnemius muscle head also. Upper portion of fibrous tissue band located on fibular rudiment is excised, tissue complex on feeding pedicle is cut out with lower fibrous tissue band portion, periosteum and lateral tibial epiphysis portion having osteochondrous part size equal to lateral malleolus size on healthy side. External and posterior ankle-joint arthrolysis is carried out. Talus reposition is carried out with prepared tissue complex being rotated to enable transferred tibial epiphysis part to take place of the lateral malleolus. Set talus position in articulation fork is to be transarticularly fixed with wires. Osteochondrous part of the transferred tissue complex on the lateral malleolus is fixed with wires.
EFFECT: enhanced effectiveness in restoring optimum anatomical and functional conditions in ankle-joint.
SUBSTANCE: method involves carrying out incomplete pericapsular osteotomy in supra-acetabular region, introducing rod having beak-shaped curvature into osteotomy zone to the level of Y-shaped cartilage. Dosed osteocartilaginous graft traction is carried out to given level and in required direction in distraction apparatus without fixing hip joint.
EFFECT: simplified operation; retained mobility in articulation; accelerated and simplified apparatus setting and removing process.
SUBSTANCE: method involves making cut in skin and subcutaneous cellular tissue running over medial surface of lower shin portion, along medial edge of heel tendon back and down enveloping medial malleolus approaching dorsal foot surface. The incision begins from upper boundary of the lower shin one-third and goes in distal direction along posterior tibia edge and in the heel tendon projection and comes to dorsal foot surface at the level of sphenonavicular joint after having passed the malleolus. Arc-shaped incision is done. The incision is turned to dorsal foot part with its apex. The incision is continued in distal direction towards medioplantar border of metatarsophalangeal articulation following flap reflectivity principle to enable one to operate on dorsal and plantar foot surface.
EFFECT: prevented flap necrosis from taking place.
SUBSTANCE: method involves creating bone block at the frontal edge level of calcaneus articulation surface by forming groove, filling it with bone graft and fixing with Kirschner wires.
EFFECT: prevented subtalar articulation hypermobility and anterointerior talus displacement without significant anatomic foot changes.
SUBSTANCE: method involves exposing spinous processes over arcuation arch, cutting them near the base and turning aside together with soft tissues. Distortion being corrected, bone bed is formed on vertebral arches with cortical layer being removed on convex side. The spinous processes are laid on the prepared bone bed so that one process overlaps two adjacent vertebrae.
EFFECT: high vertebral column stability under maximum possible correction condition.
SUBSTANCE: method involves rotating the greater trochanter after its cutting-off about the central axis in situ in a way that back portion of gluteus medius muscle is strained and anterior muscle tension becomes relaxed. The fragment is fixed in this position with screws.
EFFECT: enhanced effectiveness in preventing abduction function of gluteus muscles weakening.
SUBSTANCE: method involves suturing collateral fibular ligament, a part of patellar femur surface and fibrous capsule 2-3 cm higher and lower than joint space. Indent and pierce pass through the same hole in skin. Next, opposite thread ends are simultaneously stretched, shortening lateral stabilizing apparatus, fixed to each other with interrupted sutures immersed under the skin.
EFFECT: enhanced effectiveness in correcting lateral stabilizing structures; reduced risk of traumatic complications.
SUBSTANCE: method involves carrying out polylocal fibula osteotomy. Fibula is subjected only to osteotomy at the level corresponding to paired bone osteotomy level in distal one-third. Dosed longitudinal distraction of selected fragments is carried out. Distraction rate is reduced at the end of elongation period. Concomitant deformity is removed at distraction rate reduction stage. Stable fibula fixation is carried out after having restored biomechanical axis and required shin length.
EFFECT: avoided premature fibula synostosis, contractures and pareses.
SUBSTANCE: method involves cutting short extensor muscles of foot in metatarsophalangeal articulations projections. Long extensor muscle of the injured toe is cut at the middle phalanx level with proximal phalanges being straightened next to it.
EFFECT: improved support function; reduced tissue injuries; enabled active usage of foot at early stage.
FIELD: medicine, orthopedics, traumatology.
SUBSTANCE: 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.
EFFECT: higher efficiency of therapy.
5 dwg, 1 ex