FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used to install acetabular components of a hip joint endoprosthesis for acetabular defects. Computed tomography of the pelvis, construction of a three-dimensional model of the defect area, spatial orientation of the acetabular component of the hip joint endoprosthesis, virtual design of the implant is performed. Based on computed tomography data, modeling of the imprint of the boundaries of the remaining unchanged bone with two parallel through holes is performed. The imprint is fixed to the unchanged bone with the help of two pins inserted through the holes so that it occupies a spatial position with contact to the bone surface. A trial acetabular component of the endoprosthesis is virtually designed and manufactured from plastic in such a way that it is identical to the implant being installed in shape and size and is additionally fixedly connected to the block with through parallel holes of the device corresponding to the holes of the imprint of the unchanged bone and located in such a way that the movement of the trial acetabular component of the endoprosthesis along the axes of the spokes before contact with the acetabulum would ensure its location in the treated acetabulum. A guide is installed on the needles, made in the form of a tube, at the ends of which the first and second blocks of the device are fixedly fixed with through holes located parallel to each other and coaxially with the holes of the trial acetabular component of the endoprosthesis and the imprint of the unchanged bone area, so that the first block is in full contact with an imprint of an unaltered area of the bone. The trial acetabular component of the endoprosthesis is fixedly fixed to the second block using two bolts with nuts inserted through the holes of the trial acetabular component of the endoprosthesis and the holes of the second block. In the parallel through holes of the third movable block of the device, located on the tube between the first and second blocks and connected by means of a tension spring with a latch located on the tube in the area of the second block of the device, with the possibility of rotation around the tube and moving along the axis of the tube, parallel guides of the fourth block of the device, corresponding to the through holes of the third block, with the possibility of moving the guides in the through holes of the third block perpendicular to the axis of the guide. In the fourth block, containing a retainer for a drill with a cutter, fixedly connected to the guides, a drill with a cutter is installed and fixedly fixed so that the cutter touches the bottom of the acetabulum. Then, a depth gauge is unscrewed, located on the same axis with the axis of the drill cutter in the threaded hole of the fourth block, made in the form of a threaded stud, at the end of which there is a hemisphere, with a diameter equal to the diameter of the cutter, until it comes into contact with the surface of the trial acetabular component of the endoprosthesis. Then turn on the drill, carry out the processing of the contact point of the cutter and the bottom of the acetabulum. The depth gauge is unscrewed to the required depth of acetabular treatment, then by hand moving the fourth block and, accordingly, the depth gauge along the entire surface of the trial acetabular component of the endoprosthesis, the acetabulum and the bones surrounding it are processed, on which the elements of the installed acetabular endoprosthesis component will be fixed. After that, the guide with blocks, a trial acetabular component of the endoprosthesis, the imprint of the unchanged bone is removed. The pins are removed and the acetabular component of the endoprosthesis is installed.
EFFECT: method provides simplification of processing of the acetabulum and increasing the accuracy of bone tissue processing due to the preservation of the maximum possible amount of the processed pelvic bone.
1 cl, 5 dwg, 1 ex
