METHOD FOR PREVENTIVE FIXATION OF PROXIMAL FEMORAL BONE WITH CEMENT REPAIR FOLLOWING RADIO-FREQUENCY ABLATION FOR METASTATIC LESIONS AND THREATENING PATHOLOGIC FRACTURE Russian patent published in 2015 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology, orthopaedics and oncology orthopaedics. The method involves radio-frequency ablation, metastatic cavity curettage, cement repair with using additional tools and a fastening intramedullary structure PFN. That is preceded by manufacturing a metal pipe fitting from 250 to 300 mm long with an inner diameter equal to the diameter of a gamma nail port, which is threaded at one end at a pitch equal to the inner thread pitch of the gamma nail with the number of turns adequate to press-fit the fitting and to fasten the fitting and the gamma nail together. The other end of the pipe is threaded at a pitch equal to the inner thread pitch of a bone cement injector with the number of turns adequate to couple the fitting and bone cement injector tightly; flat mount grooves for a mounting instrument are milled at 5 mm from the last turn of the thread for coupling the fitting and bone cement injector of the pipe end together; the groove width is equal to two widths of a working part of the mounting instrument. An electrode is inserted through trephine openings along a bone trephine into the metastatic lesion, and radio-frequency ablation is performed in the cervical and diaphyseal directions. Thereafter, a trochanteric region is perforated to insert a pin; trochanteric curettage and aspiration of the RF ablated tumour are performed. A canal is formed, and the pin is inserted; that is followed by perforating in the cervical direction; where it may be necessary, cervical curettage and aspiration of the RF ablated tumour are performed through the formed perforation. The canal is further formed to insert the gamma nail, which is completely mounted and unscrewed partially so that an outlet of its central canal is aligned at the level of the cavity centre; thereafter, the respective thread is used to couple and fasten the prepared fitting first with the gamma nail, and then with the cement injector. The assembled structure is used to introduce the bone cement in the cavity; then, the fitting and injector are removed; a guide pin is inserted into the central canal, and the gamma nail is mounted completely, whereas polymerised bone cement is impacted.

EFFECT: method enables preventing the pathological fracture accompanying the metastatic lesion of the proximal femoral bone, delaying or blocking the metastatic lesion growth, postponing or avoiding a procedure of hip replacement involving proximal femoral resection.

15 dwg, 1 ex