METHOD OF PLASTY OF COXAL CAVITY AT ENDOPROTHESIS REPLACEMENT OF HIP JOINT

摘要

FIELD: medicine; surgery.;SUBSTANCE: spend clinicoradiological inspection of the patient. Estimate cavern-cystic changes of an osteal tissue and anatomo-functional defects of an coxal cavity. Define a power regimen of a bone bed and select an auto - and-or allo-bone of a corresponding microstructure. Intraoperative prepare an admixture in the form of paste or powder from crushed auto - and-or allo-bone and Kollapan. If tap individual superficial cysts, caverns or sequesters with volume not more than 5 cm³, fill the formed emptiness with the prepared paste or Kollapan gel after examination. If tap more than 30% total amount of cavern-cystic changes of reacetabular area after excising of impractical osteal tissues, fill the formed emptiness with an osteal shaving or the prepared powder. If tap destruction or absence of a part of a tectum of a coxal cavity, insufficient capping of whirlbone by it or an acetabular component, carry out reconstructive plasty of the capping placing in osteotomised split of the ileal bone over defect, a sphenoidal graft or in a cavity of defect an auto-transplant on a pedicle, and fill backlashes with the prepared admixture. If tap a protrusion and a thinning of a bottom of the coxal cavity, carry out strengthening plasty of a bottom, placing along it the grafts cut by straws, backlashes between and about which fill with the prepared powder. If tap destruction of a bottom of the coxal cavity with "the central dislocation" of the whirlbone or cup pushing out in a cavity of a small basin carry out reconstructive plasty placing on a bottom with full overlapping of defect a hemispherical graft from the top part of a head femoral hallo - or autogenous bone, or establish an antiprotrusion grid, put a shaving layer of autogenous bone and-or the prepared powder and perform impaction. If tap partial or full destruction of an anterior and-or posterior wall, carry out reconstructive plasty of the damaged wall a graft from superolateral or lateral part of a head femoral of allo - and-or autogenous bone which establish with overlapping of edges of defect, and fill backlashes with the prepared powder. If tap partial or full destruction of anterior and posterior walls and a tectum, carry out the general reconstructive plasty in steps with cut head femoral allo - and-or autogenous bone, developing fragments and combining longitudinal prominences, establishing with call in a cavity of the coxal cavity, forming an implantation bed of the obtained internal groove, and fill backlashes with the autogenous bone shaving or the prepared powder. If tap pelvic instability at catastrophic destructions of the bottom, tectum, posterior and-or anterior walls with migration of whirlbone or a cup in a cavity of the small pelvis, establish an antiprotrusion grid, make reconstructive plasty of a bottom an integral plate from compact allo bone or from the top part of a whirlbone of allo - or autogenous bone and fill a backlash between it and a grid and technological apertures of the grid by the autogenous bone shaving or the prepared powder, establish the cupon a grid in physiologically correct position then make consistently reconstructive plasty of the tectum, posterior and-or anterior walls.;EFFECT: primary and long-term stability of an endoprosthesis.;10 cl, 1 ex