Federalnoe gosudarstvennoe byudzhetnoe uchrezhdenie "Natsionalnyj meditsinskij issledovatelskij tsentr travmatologii i ortopedii imeni N.N. Priorova" Ministerstva zdravookhraneniya Rossijskoj Federats
发明人:
Golubev Igor Olegovich (RU),Голубев Игорь Олегович (RU),Balyura Grigorij Grigorevich (RU),Балюра Григорий Григорьевич (RU),Kutepov Ilya Aleksandrovich (RU),Кутепов Илья Александрович (RU)
申请号：
RU2019135174
公开号：
RU0002715920C1
申请日:
2019.11.01
申请国别(地区):
RU
年份:
2020
代理人:
摘要：
FIELD: medicine.SUBSTANCE: invention relates to medicine, particularly to traumatology and orthopedics. In the preoperative period before performing the navicular correction, the method of standard X-ray imaging is used to determine the deformity of navicular in the frontal and lateral projections, as well as by multilayer helical computed tomography, spatial visualization of involved bone structures and signs of instability of ligamentous apparatus of carpal joint of injured extremity. In the position of the patient lying down after performing axillary conductive anesthesia and treating the surgical site with antiseptic solutions, a pneumatic cuff is applied on an area of the shoulder of the operated extremity and pressure is applied in cuff 310–320 mm Hg. Injured hand is fixed in the traction tower and an extension force of 5–5.5 kg is created. Ports of the skin incision in the distal direction with width of 5–6 mm are performed for port setting, wherein the midcarpal ulnar (MC-U) port is distal to the Lister’s tubercle at 2 cm between the fourth and fifth passages of the extensor tendons, then a radial midcarpal (MC-R) port is distal to Lister's tubercle 2 cm between the third and fourth passages of extensor tendons. Mosquito-type clamp is used to dilute the soft tissues within the ports and to form access to an midcarpal joint. In midcarpal ulnar (MC-U) port an optic is introduced with diameter of 2.9 mm with inclination of lens 30°. Probe is inserted through a radial midcarpal (MC-R) port and arthroscopy is used to diagnose the volume and level of damage of navicular bone, as well as the consistency of the wrist ligament apparatus and degree of degenerative joint changes. Then, after removing the probe into the medium-wrinkled radial (MC-R) port, the nippers and the raspatory are serially inserted and the false joint area is resected to the level of the "viable" bone tissue. Lens with diameter of 2.9 mm is placed in the resection area, and lens 30° is inclined,
