METHOD FOR TWO-STAGE HIP REPLACEMENT IN CONGENITAL HIP DISLOCATION Russian patent published in 2017 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: during the first surgical intervention, neck osteotomy is performed with removal of the head. The body of the modular stem of the hip endoprosthesis is mounted, hip traction towards the cotyloid cavity to tense the muscles is carried out, and a femoral bone is fixed in the achieved position. Above the iliac wing, an incision of soft tissues is made, a support plate is placed on the iliac crest. A tunnel towards the femoral bonesaw-line is formed in the muscles. A distraction device is installed through the formed tunnel, consisting of a pivotally connected fastening unit having through holes for locking screws and a rectangular protrusion, and a cylindrical body including a rod element with a threaded portion at the free end extending beyond its end surface on the proximal end side under the action of liquid injected into the internal cavity of the cylindrical body through a hydraulic pump connected to it. The threaded portion of the rod element is connected to the support plate mounted on the ilium crest, and the protrusion of the fastening unit is inserted into the groove in the body of the monolithic stem of the endoprosthesis, further fixing the position of the device by means of locking screws installed through the through holes in the femoral bonesaw-line. A flexible tube connecting the cylindrical body with the hydraulic pump is led out through an additional puncture outside the surgical wound. In the postoperative period, the hip reduction is performed discretely in time using the installed device, increasing its length by 1-2 mm per day. When the reduction of the proximal part of the hip reaches the level of the true acetabulum, the second surgical intervention is carried out, during which the distraction device is removed and the acetabular component of the hip endoprosthesis with the head and the neck is installed, assembling the structure.

EFFECT: full reduction of the hip dislocation with minimal loss of bone mass and an improvement in the patient's life quality during the period of treatment.

1 ex, 1 dwg