RU2423932C2 - Method of recovering patella motility after dislocation in dogs - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of surgery and traumatology. Method includes general narcosis, fixation of animal in lateral position, skin cutting, approach to hip capsule and final stage of operation. Approach to patella capsule is performed by blunt method. After that, in the place of joint attachment to condyles of femur, fixed is thread by making stitches by means of alternate located in chessboard order at the distance 3-5 mm from each other stick-ins and stick-outs in direction of knee cup base. After that, when knee cup is reached, thread is passed around it in distal direction, them returned into initial point in the same manner. After that, both ends of thread are tightened with capsule crimping, restoring in this way its normal position, thread is fixed by means of knot and soft tissues, fascia lata and skin are sewn layer by layer.

EFFECT: method makes it possible to reduce degree of surgery trauma and ensure higher stability and fixation of knee cup.

Description

The present invention relates to the field of veterinary and medical equipment, namely to orthopedics and traumatology, and can be used to restore movement in the knee joint.

Dislocations of the patella lead to a decrease in limb length compared to a healthy one. Violation of supporting ability and lameness on a sick limb develop gradually.

Palpation during passive bending of the knee joint reveals free movement of the patella in the lateral or medial direction.

A complete dislocation of the kneecap is often accompanied by a subluxation of the femoral tibia and the absence of support function of this limb.

The clinical picture of dysplastic dislocation of the kneecap is usually pronounced clearly and so characteristic that the diagnosis is not very difficult.

A known method of restoring dislocation of the hip joint using an external fixation apparatus in the form of a tight bandage, which is fixed as a rigid corset. Fix the distal support base transosseously. After installing the endoprosthesis on the supporting bases, the ends of the distraction rods are fixed (1).

There is also known a method of restoring mobility of the knee joint using an apparatus containing supports with transosseous fixation elements and a hinge assembly connected to the supports. The device is equipped with a damper made in the form of arcs of flexion and extension with locks and a pair of adjustable telescopic spring-loaded joints. One of the buildings is fixed on the extension arc. Locks are made in the form of bases mounted on arcs. A threaded shank with a stop is installed in each base with a nut and a lever is pivotally mounted. The stops of one lock are in contact with the lever of another lock. The hinge assembly comprises hinge posts, a pair of telescopic joints, and a pair of articulated plates. Racks are fixed on one plate, and telescopic joints cases on the other. The connection rods are connected one to the extension arc, the other pivotally to the lock body of the extension arc. The free ends of the hinge posts are installed in the supports (2) (prototype).

Known methods are based on strengthening devices with bone grab.

The objective of our research was to develop a way to restore the mobility of the kneecap after a dislocation with the least degree of trauma of surgical interventions, increase the stability and fixation of the kneecap, and the differentiated use of surgical interventions taking into account age-related parameters.

The implementation of the tasks was achieved due to the fact that the extra-articular method of surgical treatment of the dislocation of the patella was carried out.

Fixation of the kneecap is carried out by artificial formation of fibrinous folds of the capsule of the knee joint.

The technique for restoring mobility after a dislocation of the patella involves the following manipulations.

The animal is fixed in the lateral position by the usual method, depending on the location of the dislocation, general anesthesia is performed and the surgical field is treated. During surgery, the limb is bent at the knee joint at an angle of 90 °.

Next, they begin the operation, for which a longitudinal para lateral incision is made 3-5 cm from the patella from the tibia proximally, to a point 1-2 cm above the patella and at the same level an incision is made of the broad fascia of the thigh. Then a blunt method makes access to the capsule of the knee joint.

At the place of attachment of the joint capsule to the condyles of the femur, the thread is fixed and stitches are made in the direction of the base of the patella by alternating injections and punctures located staggered at a distance of 3-5 mm from each other. When they reach the kneecap, they circle the thread in the distal direction and return to the starting point in the same way. Then both ends of the thread are pulled together, corrugating the capsule of the cup, and the thread is fixed in a knot.

The final part is carried out by layer-by-layer suturing of soft tissues, wide fascia of the thigh and skin.

In the postoperative period, the sutures are treated with an alcoholic solution of brilliant green for 10-12 days, a weekly course of antibiotic therapy and a calm exercise are prescribed. Sutures are removed on the 10-12th day. If necessary, the application of a plaster cast is recommended.

We also tested a method for recovering a kneecap after an injury on cats. It is carried out similarly to the method of restoring dislocation of the kneecap in dogs, taking into account the lower anatomical parameters of the joint.

The proposed method allows you to:

- reduce the degree of trauma of surgical interventions;

- provide increased stability and fixation of the patella;

- use the differential use of surgical interventions taking into account age-related parameters.

The proposed method was tested with a positive result in the MBA Department of Surgery in 1996-2009. on dogs.

The method will find application in dog breeding organizations, border troops and among private dog owners.

Information sources

1. Patent RU No. 2306894, 2007 / C1 A61B 17/60.

2. Patent RU No. 2021777, 1994 / C1 A61B 17/00.

Claims (1)

A method for restoring the mobility of a kneecap after a dislocation in dogs, including general anesthesia, fixing the animal in a lateral position, skin incision, approach to the capsule of the thigh and the final stage of the operation, characterized in that the approach to the capsule of the knee joint is performed using the blunt method, at the point of joint attachment to the thread is fixed to the condyles of the femur, making stitches alternately staggered at a distance of 3-5 mm from each other and punctures of stitches in the direction of the base of the patella, and, reaching the patella, the contour m around the thread in the distal direction, and then returning to the starting point the same way, and then both ends of the thread pull together, crimping the capsule, thus restoring its normal position, the thread is fixed node and soft tissue sutured in layers, fascia lata and skin.