Anterior prompt for debridement and myoplasty femoral neck and head osteomyelitis
https://doi.org/10.25199/2408-9613-2021-8-2-34-40
Abstract
The known anterior prompts to the femoral neck are non-traumatic, but they exclude the possibility of myoplasty and are not large enough for intra-articular sequestrectomy.
Objective. The aim of the study was to develop an anterior prompt to the hip joint for sequestrectomy with myoplasty.
Materials and research methods. For surgery neck and head of the hip osteomyelitis we perform a semi-oval incision in the projection of the femoral head, from the anterior spines of the ilium we cut off the tendons of the sartorius and rectus head of the quadriceps femoris muscles. An operating field is formed, which allows sequestrectomy to be performed. Plasty of the osteomyelitis cavity is performed with the proximal parts of the two anterior ileofemoral muscles. The operating field, if necessary, can be increased by temporary transection of the lumbar-iliac muscle tendon.
Research results. The key to the anterior surgical prompt to the hip joint is the sartorius and rectus head of the quadriceps. The length of the surgical wound reaches 17–22 cm, and the width is 16–18 cm. With the mobilized proximal part of the sartorius muscle, we fill the entire bone cavity in the neck and head of the femur. Of the 12 operated patients, 11 (91.7 ± 7.6 %) had a stable long-term remission.
Conclusion. The proposed approach is less traumatic and allows you to operate at an angle of about 90°. It complements the advantages of the known anterior prompts and is devoid of their disadvantages.
About the Authors
V. M. Bensman
FSBI of HE “Kuban State Medical University” of the Ministry of Health of Russia
Russian Federation
Russian Federation
4 Mitrofan Sedin Str., Krasnodar, 350063, Russia
Yu. P. Savchenko
FSBI of HE “Kuban State Medical University” of the Ministry of Health of Russia; GBHI “Professor S. V. Ochapovsky Research Institute – Krasnodar Regional Clinical Hospital No. 1” of the Ministry of Health of the Krasnodar Region
Russian Federation
Russian Federation
4 Mitrofan Sedin Str., Krasnodar, 350063, Russia; 167 First of May Str., Krasnodar, 350086, Russia
V. V. Malyshko
FSBI of HE “Kuban State Medical University” of the Ministry of Health of Russia
Russian Federation
Russian Federation
4 Mitrofan Sedin Str., Krasnodar, 350063, Russia
References
1. Popkirov S. Purulent-septic surgery = Popkirov S. Gnoyno-septicheskaya khirurgiya. Sofiya: Meditsina i fizkul’tura, 1974. 502 s. (In Russ.)
2. Selivanov V. P., Voronyansky Yu. P. Osteomyelitis of the pelvis = Selivanov V. P., Voronyanskiy Yu. P. Osteomielity taza. M.: Meditsina, 1975.160 s. (In Russ.)
3. Gerasimenko M. A., Vrublevsky V. A., Gerasimov A. G., et al. Direct anterior approach in total hip arthroplasty: a literature review = Gerasimenko M. A., Vrublevskiy V. A., Gerasimov A. G. i dr. Pryamoy peredniy dostup v total’nom endoprotezirovanii tazobedrennogo sustava. Meditsinskiy zhurnal. 2018; 2: 4–7. (In Russ.)
4. Chaklin V. D. Operative surgery = Chaklin V. D. Operativnaya ortopediya. M.: Meditsina, 1961. 738 s. (In Russ.)
5. Kornev P. G. Surgery of osteoarticular tuberculosis = Kornev P. G. Khirurgiya kostno-sustavnogo tuberkulyoza. M.-L.: Meditsina, 1964. 550 s. (In Russ.)
6. Kabanov V. N. Comparison of surgical approaches to the hip joint and the search for ways to modernize them from the point of view of clinical morphometry = Kabanov V. N. Sravneniye khirurgicheskikh dostupov k tazobedrennomu sustavu i poisk putey ikh modernizatsii s tochki zreniya klinicheskoy morfometrii. Izvestiya vuzov. Severo-Kavkazskiy region. Yestestvennye nauki. 2006; 2: 106–111. (In Russ.)
7. Krasovitov V. K. Resection of the hip joint = Krasovitov V. K. Rezekciya tazobedrennogo sustava. Krasnodar, 1956. 126 s. (In Russ.)
8. Lingart V. Guide to Operative Surgery = Lingart V. Rukovodstvo k operativnoy khirurgii. M., 1876. T. 1, kn. 2. S. 435-439. (In Russ.)
9. Voino-Yasenetskiy V .F. Essays on purulent surgery = Voyno-Yasenetskiy V. F. Ocherki gnoynoy khirurgii. M.: Medgiz, 1946. 544 s. (In Russ.)
10. Gostishchev V. K. Operative purulent surgery = Gostishchev V. K. Operativnaya gnoynaya khirurgiya. M.: Meditsina, 1996. 415 s. (In Russ.)
11. Nikitin G. D., Rak A. V., Linnik S. A., et al. Bone and musculoskeletal grafting in the treatment of chronic osteomyelitis and purulent pseudoarthrosis = Nikitin G. D., Rak A. V., Linnik S. A. i dr. Kostnaya i myshechno-kostnaya plastika pri lechenii khronicheskogo osteomielita i gnoynykh lozhnyh sustavov. SPb.: LIG, 2002. 192 s. (In Russ.)
12. Prokhorenko V. M., Turkov P. S. Influence of position of femur proximal part on the choice of quick access = Prokhorenko V. M., Turkov P. S. Vliyaniye polozheniya proksimal'nogo otdela bedrennoy kosti na vybor operativnogo dostupa. Meditsina i obrazovaniye v Sibiri. 2013; 3: 21. (In Russ.)
13. Hallert O., Li Y., Brismar H., Lindgren U. The direct anterior approach: initial experience of a minimally invasive technique for total hip arthroplasty. J Orthop Surg Res. 2012; 7 (1): 17.
14. Patent RF na izobretenie №2337629/ 10.11.2008. Byul. № 31. Bensman V. M. Method of anterior access to the hip joint = Bensman V. M. Sposob perednego dostupa k tazobedrennomu sustavu. (In Russ.)
15. Patent RF na izobretenie №2342908/ 10.01.2009. Byul. № 1 Bensman V. M. A method for the surgical treatment of chronic osteomyelitis of the neck, femoral head and anterior acetabulum = Bensman V. M. Sposob khirurgicheskogo lecheniya khronicheskogo osteomielita sheyki, golovki bedra i perednego otdela vertluzhnoy vpadiny. (In Russ.)
16. Corning H. K. Topographic Anatomy Guide = Сorning G.K. Rukovodstvo po topograficheskoy anatomii. Berlin: Izd-vo “Vrach”, 1923. 696 s. (In Russ.)
17. Kovanov V. V., Travin A. A. Surgical anatomy of the lower extremities = Kovanov V. V., Travin A. A. Khirurgicheskaya anatomiya nizhnikh konechnostey. M.: Medgiz, 1963. 567 s. (In Russ.)
Review
For citations:
Bensman V.M., Savchenko Yu.P., Malyshko V.V. Anterior prompt for debridement and myoplasty femoral neck and head osteomyelitis. Wounds and wound infections. The prof. B.M. Kostyuchenok journal. 2021;8(2):34-40. (In Russ.) https://doi.org/10.25199/2408-9613-2021-8-2-34-40
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