METHOD FOR HIP ARTHROPLASTY IN A HIGH-ENERGY DOUBLE COLUMN ACETABULAR FRACTURE WITH DISLOCATION OF CENTRAL TYPE

摘要

FIELD: medical equipment.;SUBSTANCE: invention relates to traumatology and orthopedics and can be used for hip arthroplasty in a high-energy double column acetabular fracture with dislocation of central type. Method comprises resecting a femoral head and femoral neck, removing them from the acetabulum. Transplant from the femoral head is being formed by sawing off the neck from the head and a osteochondral fragment from the opposite side of the head. On the side of sawing off the neck from the head, the bone fragment is being resected at an angle of 30° to the sawing plane and occupying 1/3 of the sawing area. Cartilagineus layer is being removed from the head. Cartilagineus layer of the acetabulum is being removed without injuring the protruding fragment of one of its walls. Treated transplant of the femoral head is being immersed in the acetabulum with turning the transplant in the frontal plane by 180° and then turning in the sagittal plane so that canted surface of the transplant formed as a result of neck sawing is being placed on the protruding bone fragment of the acetabulum. Treated transplant is being impacted into the cavity, treated with a hemispherical cutter until the moment of forming a round shape with a 3–5 mm transplant thickness. Wall defects are being eliminated by impaction of bone chips obtained after cutting an acetabulum with the placed transplant. Support ring is being mounted with screws. Polyethylene monoblock of the endoprosthesis is being placed on the bone cement in the outer hemisphere of the support ring. Endoprosthesis leg is being mounted in the femoral bone canal, the endoprosthesis head is being inserted on the leg cone and inserted into the acetabulum.;EFFECT: method allows to reduce traumatism, create conditions for full consolidation of the acetabular fracture, provide early rehabilitation of the patient.;1 cl, 11 dwg