RU2510249C1 - Method of treating hip dislocation in small laboratory animals - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, veterinary science, orthopaedics, namely to methods of treating a hip dislocation in small laboratory animals by means of subcutaneous fixators. An open reposition of the hip dislocation is followed by a perforation of a femoral bone, femoral neck and head and an iliac bone along a medial line at an angle to a distal line of the femoral bone with using a guide drill. A triangular-pointed stylette is removed from a guide drill sleeve and replaced by a doubled primary suture to be brought out from the femoral bone, femoral neck and head, and the iliac bone from the medial line of the iliac bone. Another intermediate suture is threaded into a loop formed thereby. The guide drill sleeve is removed from the drilled canal thereby spinning the primary and intermediate sutures. A fixing suture is inserted into a loop of the intermediate suture and drawn through a bone canal; thereafter, nylon monofibre and an orthopaedic pin are inserted into the loop from the medial surface of the iliac bone. A primary loop is drawn from the bone canal, pressed to the iliac bone so that an upper portion of the pin or monofibre extends into a greater trochanter. On the side of the femoral bone, the suture is knotted three times with the orthopaedic pin pre-inserted between the knot and bone, with the loop or double suture with the ends brought out under the skin within the grater trochanter. Then 10-14 days later, the skin within the greater trochanter is incised, and the rest is pulled out on the side of the iliac bone; then the double monofibre that retracts the suture fastened on its end, is removed with demounting the structure supporting the joint.

EFFECT: method enables eliminating the defects of the proximal hip and cotyloid cavity, recovering the spatial relationships in the hip joint by improving the methods for fixation accompanying the hip dislocation.

10 dwg

Description

The invention relates to the field of medicine, veterinary medicine, orthopedics, and in particular to methods for treating hip dislocation in small pets with subcutaneous fixation.

A known method of treating dislocations of the hip joint in small animals by general anesthesia, reduction of the joint and temporary fixation of the inserted hip joint by introducing one metal L-shaped pin through the head of the joint into the thickness of the pelvic bone through an incision on the skin of the animal. As a pin, a pointed metal needle is used, the bent outer end of which, after insertion, is sutured under the skin of the animal. The pin is kept under the skin of the animal for 14-15 days, after which it is removed. As a pin, a straightened skin-muscle surgical needle of a trihedral profile can be used (RU, application for invention No. 99121241/13, IPC А61В 17/74, А61В 17/78, А61В 19/00, A61D 1/00, publ. 02.27.2000 g .).

This method does not stably fix the hip joint with a possible bending of the fixing needle or needle.

There is also a method of treating damage to the hip joint in small domestic animals, including stable fixation and reposition of the structures of the hip joint and / or its fragments using a compression-distraction apparatus in combination with medical therapy courses (RU, patent application No. 2008102256/13, IPC A61D 99/00, published July 27, 2009).

The disadvantages of this method include the inconvenience of using such a bulky design, the need to care for the device, the animals are trying to get rid of it.

The closest solution is the method of surgical surgery for fixing the femoral head in the acetabulum using threads (from non-absorbable material), conducted through the roof of the acetabulum and the channel drilled at the base of the femoral neck. To do this, two strands are held back, and two in the form of a figure eight. The ends of the threads are tied with a slight abduction and rotation of the femur, then the wound is closed (Horst Shebits, Wilhelm Brass. Surgical surgery of dogs and cats. Second revised edition. - M .: Aquarium, 2001, p. 426-428) - prototype.

This method allows the fixation of the femoral head, however, this design is difficult to remove (requires additional surgery) and is not reliable enough.

The objective of the present invention is to improve the known methods of fixation for dislocation of the femur of small animals.

The technical result that will be achieved from the use of this invention is to eliminate the defects of the proximal femur and acetabulum and restore spatial relationships in the hip joint.

The technical result is achieved by the fact that the method of treatment of dislocation of the femur in small domestic animals is carried out by fixing the femur in the acetabulum using threads, perforation of the neck of the femur and acetabulum of the ilium, closing the wound with a suture, followed by drug therapy. Moreover, in addition to perforation of the neck of the femur and the acetabulum of the ilium, the femur and its head are also perforated. In addition, the perforation is carried out along the medial line at an angle to the distal line of the femur using a drill-conductor. The stylet is removed from the drill-conductor and a primary thread, doubled up, is inserted instead of it, into the formed loop of which then another, intermediate, thread is inserted from the medial side of the ilium. Then, the sleeve of the drill-conductor is removed from the drilled channel, while pulling the primary and intermediate threads. Then, a fixing thread is inserted into the loop of the intermediate thread and pulled through the bone channel, after which a nylon monofilament or orthopedic (metal) needle is inserted into its loop from the side of the medial surface of the ilium. After that, the main loop is pulled from the bone canal, pressed to the ilium so that the upper part of the knitting needle or monofilament extends into the region of the greater trochanter, then from the side of the femur, the knot is tied to three knots with a metal knitting needle with a loop preliminarily inserted between the knot and bone or a double thread (monofilament), the ends of which are brought out under the skin in the region of the greater trochanter. After 10-14 days, the skin in the region of the greater trochanter is incised and a stubborn thread or orthopedic needle is pulled out from the ilium, then a double monofilament is pulled out, which extends the thread fixed to its end, removing the entire joint fixing structure.

The essence of the invention lies in the reliable fixation of the femoral head in the acetabulum using threads (nylon monofilament) Yu perforated using a special drill-conductor along the medial line of the femur, neck, femoral head and ilium using the original design of the drill-conductor.

This technique allows you to securely fix the femoral head in the acetabulum at the same time eliminates compression on the cartilage of the joint due to the elasticity of the monofilament of the fixing thread, eliminating the subsequent development of arthrosis. To prevent the same complications, the conductor drill passes through the fixation sites of the round ligament both on the femoral head and on the acetabulum. The drill is made of stainless steel with a diameter of 1: 8 of the diameter of the femoral head. During the drilling of the stylet, sharpened to a triangle, during drilling, the conductor pushes the bone and cartilage tissue to the exclusion of contamination of the wound surface with bone crumbs that appear during drilling with a conventional drill.

During forced fixation, an inflammatory capsule is formed within 10-14 days, and then a joint capsule, which firmly determines the position of the femoral head in the acetabulum.

From an analysis of the scientific, technical and patent literature of the claimed combination of methods for the treatment of dislocation of the femur, ensuring reliable fixation of the femoral head in the acetabulum, allowing to eliminate defects in the proximal femur and acetabulum and to restore spatial relationships in the hip joint, we have not identified that allows us to do conclusion on the conformity of the claimed technical solution to the criteria of "novelty" and "inventive step".

The invention is illustrated by the following images, where:

figure 1 shows the drill conductor,

figure 2 - stylet drill-conductor,

figure 3 is a diagram of the fixation of the femoral head, stage 1;

figure 4 is the same, step 2;

figure 5 is the same, step 3;

figure 6 is the same, step 4;

Fig.7 is the same, step 5;

Fig.8 is the same, step 6;

figure 9 is the same, step 7;

figure 10 is the same, step 8.

The drill-conductor consists of a sleeve 1, with slots 2, a stylet 3 with a trihedral tip 4 and the opposite end 5 with 2-sided cuts 5a (see figure 2).

The invention is as follows.

After reposition by open method, dislocation of the femur 6 in the acetabulum 9 (Figs. 3, 4) is drilled with a trihedral tip 4 of the stylet 3 of the drill-conductor (inserted into the sleeve 1 and securely fixed to the opposite end 5 (5a) in the slots 2) along the medial line of the femur bone 6, neck 7 and head 8 of the thigh, ilium 10 (Figure 5). The stylet 3 with a trihedral tip 4 is removed from the sleeve 1 of the conductor drill and inserted into the sleeve 1 instead of it is a nylon monofilament (primary thread) 11, twisted twice, and it is brought out through the femur 6, neck 7 and femoral head 8 and ilium 9 s the medial side of the ilium 10. In this way, the loop of the thread 11 is inserted another intermediate thread 12 (Fig.6). Then the drill-conductor is removed from the drilled bone canal, while pulling the intermediate filament 12 from the canal. The primary filament 11 is removed, and instead of it, the main filament 13 is inserted into the intermediate loop 13 to fix the joint (Fig. 7) and pulled from the medial side the surface of the ilium 10. In the loop of the main thread 13 from the side of the medial surface of the ilium 10, an emphasis 14 is inserted in the form of a nylon fiber or orthopedic metal needle (Fig. 8), after which the main thread 13 is pulled from the bone canal, clamp I stop 14 to the medial surface of the iliac bone so that the upper part of the fence 14 (fibers or spokes) come out to the greater trochanter (9). From the side of the femur 6 (Fig. 9), a thread 13 is tied into three knots, after inserting a metal needle with a loop 15 (or a double nylon monofilament) between the knot and bone 6 with the ends brought out under the skin in the region of the greater trochanter (not shown in the diagram) . The wound is closed with a skin suture. After 10-14 days, the skin in the region of the greater trochanter is incised and the support 14 is pulled out from the side of the ilium 9. After that, the spoke 14 is removed from the side of the femur 6, thereby removing the entire fixing structure (Fig. 10). If necessary, a suture is applied to the skin incision site.

Treatment therapy after surgery includes: antibiotics for 6 days (Amoxicillin at a dose of 15 mg / kg once every two days, 3 injections). After normalization of the total body temperature, Actovegin solution is intramuscularly administered at a dose of 1 ml (40 mg) once a day for 14 days, and Hondartron is administered intramuscularly at a dose of 0.07 ml / kg once a day for 10 days. Suture treatment is carried out with terramycin once a day for 14 days.

Thus, the claimed technical solution allows, compared with the prototype, to more stably fix the femoral head in the acetabulum. Combining the attachment points of the round ligament, a more correct anatomical position of the joint bones is created, which ensures the prevention of possible joint arthrosis. In addition, the use of an elastic material - monofilament allows some abduction of the femur not only outward, but also inward, whereas, according to the prototype, the movement of the femur can only be outward.

Claims (1)

A method for the treatment of dislocation of the femur in small domestic animals, including fixation of the femur in the acetabulum using filaments, perforation of the femoral neck and acetabulum of the ilium, closure of the wound with a suture, subsequent drug therapy, characterized in that the perforation of the femur, neck and the heads of the femur and ilium are carried out along the medial line at an angle to the distal line of the femur using a drill-conductor, removing the stylet from the drill-conductor and instead, by pressing the primary thread, doubled up, into the formed loop of which, then, another intermediate thread is inserted from the medial side of the ilium, after which the sleeve of the drill-conductor is removed from the drilled channel, while pulling the primary and intermediate threads, the fixing thread is inserted into the loop of the intermediate thread the thread and pull it through the bone channel, after which a nylon monofilament or orthopedic needle is inserted into its loop from the side of the medial surface of the ilium as an abutment, after they pull the main loop from the bone canal, press it to the ilium so that the upper part of the knitting needle or monofilament extends into the region of the greater trochanter, then from the side of the femur, the thread is knotted into three knots with an orthopedic knitting needle pre-inserted between the node and the bone or double thread, the ends of which are brought out under the skin in the region of the greater trochanter, after 10-14 days, cut the skin in the region of the greater trochanter and pull out the emphasis from the ilium, then take out the double monofilament, cat Roe pulls mounted on its end a thread, removing all the fixing joint design.

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