FIELD: medical science.
SUBSTANCE: group of inventions relates to medicine, specifically to orthopaedics, and can be used for treating gonarthrosis accompanying medial joint hyperpressure wherein tibial osteotomy and fragments fixation with an external fixation apparatus are performed. External fixation apparatus is used, comprising two distal annular supports connected to each other by three threaded rods, two proximal annular supports interconnected by four threaded rods, a middle annular support located between the distal and proximal annular supports. Middle support is connected to nearest distal ring support by means of four hinge joints. Nearest proximal support is connected with middle support by means of two threaded rods with hinge joints, which are arranged on lateral and medial surfaces of knee joint symmetrically in projection of joint rotation axis. Middle support is provided with a fixation rod which is attached to the nearest proximal and distal supports along an anterior surface of the knee joint. Wires are delivered through a distal femoral epiphysis and at the interface of a middle and lower one-third of a femoral shaft. Two annular supports are mounted, connected to each other by threaded rods, the proximal support on the shin and the distal support on the thigh are connected to each other by means of two hinge joints mounted on the side surfaces of the knee joint symmetrically in the projection of the axis of rotation of the knee joint, as well as a fixing threaded rod along the front surface of the knee joint. Partial correction of shin deformity is performed, as well as correction of position of joint space by means of distraction along medial pin with hinge joint between supports on shin and thigh. On the first postoperative day, therapeutic exercises for the knee joint are started. In the postoperative period, under X-ray imaging control, performing the remaining shin deformation correction, as well as graduated alignment of joint space height; medial side is distracted along a medial pin with a hinge joint arranged in a projection of a joint rotation axis, while compression is performed from a lateral side to achieve a uniform height of a joint space. Joint space alignment and shin deformity elimination are followed by unloading a medial portion of the joint and daily therapeutic physical training of the knee joint. After the formation of regenerates, the apparatus is dismantled.
EFFECT: group of inventions provides the graduated decompression of the hyperpressed knee joint and alignment of the height of the joint space with elimination of the bone and soft-tissue component of the knee joint deformation by eliminating the joint space misalignment and shin deformation.
2 cl, 6 dwg, 2 ex
