METHOD OF WHIRLBONE CHONDROEPIPHYSECTOTOMY AT PATIENTS WITH HIP JOINT MIXED ARTHRITIS (METHOD OF MALOVICKKO V) Russian patent published in 2009 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention concerns medicine area, namely to traumatology, orthopedy and after treatment, by the ways of whirlbone chondroepiphysectotomy at patients with a mixed hip joint arthritis. Surgical access by performance of an arched cut of a skin in length of 15-18 cm in a projection of forward department of a crest of an ileal bone through the top forward arista and downwards on a frontexternal surfacy of ahip joint is provided further. The fatty tissue, a forward fascia and own fascia of a hip is dissected layer by layer. In a blunt and sharp manner it is penetrated between a tailor's muscle and a muscle straining a wide fascia. Thus the tailor's muscle is taken away medially, and a muscle straining a wide fascia is taken away laterally and to the back. Then blunt penetration between an iliolumbar muscle and forward department of average and small cluneal muscles is performed. The rectus muscle of thigh which has been found out in the heart of the wound is taken away to the inside with a denudation of a layer of a prearticulate fat as internal reference point for detection of a capsule of a hip joint. The section of a capsule of a hip joint is carried out T-shapedly by the basis to an acetabular hollow on a forward surface with a denudation of a head of a coxofemoral bone, which is dislocated from an acetabular hollow in the wound. The cartilage is removed from the whirlbone to the subchondral bone at cartilage conservation in an acetabular hollow. Thus in case of appreciable narrowing of an articulate cleft and complicated access to the whirlbone the osteotomy of an epiphysis of the whirlbone with the subsequent dislocation from an acetabular hollow is carried out. Then from an acetabular hollow the freely lying osteotomised sites of the whirlbone and a cartilage to the subchondral bone are removed. Then after performance of resection arthroplasties the operated lowerlimb of the patient is taken aside on an angle of 20-30 degrees, it keeps within and fixed in the derotation brace in functionally neutral position. The operational wound is washed out and drained by the bipolar drainage, performed in a longitudinal direction over a surface of the resected hip joint. The wound is taken in layer by layer with simultaneous homing to the anatomic places of the abducted uncrossed muscles.

EFFECT: method allows to frame full restoration of painless, basic and impellent function of a joint.

2 cl, 2 ex