METHOD OF SURGICAL TREATMENT OF MALIGNANT GROWTHS WITH THE DEFEAT OF THE COTYLOID CAVITY, WING OF ILIUM AND PROXIMAL FEMUR WITH RESECTION OF COTYLOID CAVITY AND FIXATION OF COTYLOID COMPONENT OF ENDOPROSTHESIS IN SACRUM
Federalnoe gosudarstvennoe byudzhetnoe uchrezhdenie "Natsionalnyj meditsinskij issledovatelskij tsentr travmatologii i ortopedii imeni N.N. Priorova" Ministerstva zdravookhraneniya Rossijskoj Federats
发明人:
Zagorodnij Nikolaj Vasilevich (RU),Загородний Николай Васильевич (RU),Karpenko Vadim Yurevich (RU),Карпенко Вадим Юрьевич (RU),Karasev Anatolij Leonidovich (RU),Карасев Анатолий Леонидович (RU),Ilurid
申请号：
RU2019131847
公开号：
RU0002722935C1
申请日:
2019.10.09
申请国别(地区):
RU
年份:
2020
代理人:
摘要：
FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to traumatology and orthopedics, and can be used in surgical management of patients with malignant neoplasm of pelvic bone in conditions of oncological hospitals. In the preoperative period prior to surgical management, spatial visualization of involved bone structures of pelvic and femoral bones is determined by multilayer helical computed tomography. Method of magnetic resonance tomography is used to evaluate the condition of surrounding soft tissues, vascular and nerve structures that are not visualized when performing multilayer spiral computed tomography. In the patient's position, an arcuate incision of skin and subcutaneous fat along an iliac crest from an anterior superior iliac spine to a projection of a greater ischial incision are performed in an anesthetized healthy segment. Using the electric knife, the skin flap is separated along the external surface of the iliac bone, the inguinal ligament is transected, the fibers of the external abdominal oblique muscle are dissected at the attachment point to the iliac bone, and the retroperitoneal approach to iliac vessels is performed with the iliac vessels visualization. Skeletonized an anterior spines of iliac bone with excision of sartorius muscle and rectus femoris muscle. Incision on the anteriolateral surface of the femur is prolonged more caudally, a femoral neurovascular bundle is visualized and its stroke is monitored. Hip joint is accessed, the proximal femoral part is separated from the surrounding tissues and 2–3 mm from the distal edge of the tumor, the femoral osteotomy is performed for the subsequent placement of the femoral component of the oncology endoprosthesis. Gluteus muscles are dissected in layers with visualization, separation, dressing and intersection of the lower and upper gluteus vascular bundles. Muscles of the internal group of pelvic muscles are transected, an access to the ischial nerve and an iliac joint is visualize
