METHOD FOR CONDUCTING PLASTY OF POSTRESECTIONAL DEFECT IN TIBIAL PROXIMAL DEPARTMENT WITH FIBULAR AUTOTRANSPLANT UPON AREA OF NOURISHING TISSUES

摘要

FIELD: medicine. SUBSTANCE: in children at detecting malignant tumors in tibial proximal department, during one stage after resection of tumor-affected tibial proximal department and removing it out of a knee joint, one should form a bed in articular femoral surface according to the shape of fibular caput, the bottom of which is represented by spongy substance. Canal of tibial distal stump should be broadened up to fibular diameter, fibula should be crossed perpendicularly against its axis in distal department with the help of special saw at maximum distance against fibular caput, the latter should be than removed out of tibiofibular articulation to liberate it against cartilage, then the bone should be mobilized and together with area of nourishing tissues it should be replaced into position of resected tibial proximal department with tumor by placing the caput of fibular transplant into the bed in articular femoral surface by, thus, developing ankylosis in knee joint, distal end of fibular transplant should be deepened for 2- 3 cm into a canal in tibial stump, then Ilizarov's apparatus should be used by applying per two pairs of Kirschner's needles in mutually perpendicular planes through distal femoral department and tibial stump and one pair of needles of 1.5 mm diameter through middle third of the transplant, then one should suture postoperative wound by layers by leaving helpful polyvinylchloride drainage that enables to keep the limb with its capacity for support. EFFECT: higher efficiency of plasty. 1 dwg, 3 ex