METHOD OF REVISION PLASTIC HIP REPLACEMENT IN UNSTABLE ENDOPROSTHESIS COMPONENTS INSERTED IN WING OF ILIUM IN CONGENITAL HIGH HIP DISLOCATION

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely traumatology and orthopaedics, and is applicable for the purpose of revision operations on hip joint. At the first stage, a posterioexternal approach to the hip joint is performed. Two holes are formed crosswise along a posterioexternal surface of femur below an end of an endoprosthesis leg. A cortical layer of the bone is transected between these holes. The holes shaped after the endoprosthesis leg are formed on both ends of the posterior and anterior surfaces of femur to make marks for V-osteotomy. Osteotomy without dissecting a greater trochanter away and with preserving ventral gluteal muscle, gluteus minimus muscle and vastus muscle is performed. A formed muscle-coated skin flap is drawn back to expose a marrowy canal. The endoprosthesis leg and a cement mantle are removed. A femoral head is dislocated from a cotyloid position. After the cotyloid component is removed together with the cement mantle from the wing of ilium; the formed bone bed is packed with surrounding tissues; the upper layers are tightly closed. Then dissected bone fragment is placed back in place and fixed with wire sutures. The wound is closed. A proximal end of femur is reduced to a level of the cotyloid cavity. At the second stage, the bone bed is formed in the true cotyloid cavity; the cotyloid component is implanted therein, and an open part of the cup is reinforced with an allograft. A dissected bone cover is opened on a proximal end of femur. A revision hip component is implanted so that a centre of the femoral head is placed on the same horizontal line with an apex of the preserved greater trochanter. The femoral head is set into the cotyloid component. The wound is closed.;EFFECT: method provides preventing developing unstable components of the endoprosthesis, reducing an extremity length, tissue injuries, blood loss, postoperative complications, and length of operation.;1 ex, 15 dwg