FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to orthopedics, and is intended for use in the surgical treatment of children with necrosis of the femoral head. At first, an angular incision of the skin and subcutaneous tissue in the upper third of the thigh on the outer surface is made. After a cruciate dissection of the wide fascia of the thigh, the anterior-inferior iliac spine is isolated in layers between the muscle straining the wide fascia and the gluteus maximus muscle. Then, the cartilaginous apophysis of the iliac crest is longitudinally dissected to the anterior superior iliac spine. Next, the incision is extended down to the front-lower spine. And the iliac bone is subperiosteally exposed from the anterior-inferior spine to the large sciatic notch into which the Gigli saw is inserted. After that the osteotomy of the Ilium is performed from the large sciatic notch to the anterior-lower spine. Further, the acetabular fragment is rotated outwards and anteriorly until the femoral head is completely covered. The allograft or autograft is inserted into the diastasis between the fragments. And the osteotomy fragments are fixed in the position of the correction with Kirschner needles. In the projection of the greater trochanter, the lateral head of the musculus quadriceps femoris along with the periosteum is dissected in a T-shape, the femoral bone in the upper third is exposed subperiosteally. And the center of the figure-of-eight-shaped plate is located from the lateral surface of the femur above the growth zone of the greater trochanter; above and below the latter through the holes in the plate two screws are attached. Then, the wound is sutured in layers, leaving drainage. It is followed by application of an aseptic bandage. Lastly, a control x-ray is made and immobilization of the lower extremities is ensured.
EFFECT: method allows to increase the effectiveness of surgical treatment of children with necrosis of the femoral head through the correction of the growth of the greater trochanter.
1 cl, 5 dwg
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Authors
Dates
2018-12-28—Published
2017-08-16—Filed