FIELD: medicine.
SUBSTANCE: invention relates to field of medicine, in particular, to traumatology and orthopedics. Skin cut in projection of greater trochanter of femur from 10 to 15 cm long is made. Cut is started 4-5 cm above trochanter. Layer-by-layer incision of subcutaneous-fatty cellular tissue and fascia lata is performed in the same direction as skin cut and along its entire length with length necessary for access to hip joint but without possibility of supratrochanteric area exposure. Muscle that strains fascia lata is intersected. Longitudinal cut of middle gluteal muscle and lateral head of quadriceps femoris at the level of greater trochanter of hip bone is performed. Dissected musclea are brought apart by means of Homan retractors, joint capsule being excised within sight. After that, hip is dislocated with intersection of round ligament of hip. Osteotomy of femoral neck is performed. Head is ablated. Excision of capsule residues is carried out. Processing of available acetabulum and resected femoral head, which have maximally congruent shape, is performed. After that, resected femoral head and available acetabulum are cleaned from cartilaginous cover. Zone of subchondral sclerosis is removed until spongy substance appears on their surface. Structural autotransplant is pressed to available dysplastic acetabulum and fixed preventively. Position and degree of transplant contact with bed are controlled. Fixation of autotransplant with spongy screws in its upper part is performed. After that, bed for acetabular component of endoprosthesis is formed with standard cutters. Installation of acetabular component is carried out by its ramming into obtained bed, which is 1.8-2.0 mm smaller than diameter of acetabular component.
EFFECT: method ensures transplant adaptation in defect zone to shape of acetabulum roof edge, reduction of post-operation complications.
2 cl, 1 ex, 9 dwg
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