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首页> 外国专利> METHOD OF SURGICAL TREATMENT non-united fractures and false joints TUBULAR BONES IN THE PRESENCE OF DEFICIT PROJECTIONS soft tissues in the non-united fractures and false joints

METHOD OF SURGICAL TREATMENT non-united fractures and false joints TUBULAR BONES IN THE PRESENCE OF DEFICIT PROJECTIONS soft tissues in the non-united fractures and false joints

机译：出现缺损项目的手术治疗不合并骨折和假关节的肾小管骨不合并骨折和假关节的软组织的手术治疗

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FIELD: chemistry.;SUBSTANCE: invention relates to medicine and specifically to trauma surgery and orthopaedics, and can be sued for surgical treatment of ununited fractures and false joints of cylindrical bones when there is a shortage of soft tissue. The method involves, 5-6 days before an operation, performing needle biopsy of bone and soft tissue fragments from the damage centre of the cylindrical bone and determining presence and nature of obligate intracellular viral infection (OIVI). Super-selective angiographic analysis of the microvascular channel to the capillary link is also performed. Valtrex is administered to the patient 2-4 days before the operation in a dose of 500 mg twice a day. Further, the method involves performing osteosynthesis or re-osteosynthesis with resection of the ends of bone fragments, opening marrowy canals, bone stimulation and batting the space of the bone defect with a gel-like nanostructured composite implant. In the presence of OIVI, resection of bone fragments is carried out in a larger volume until the onset of "pinpoint bleeding", i.e. to areas with satisfactory intrabone blood supply. The composite implant contains thrombocyte-rich autoplasma, mixed in ratio of 1:(1-2) with granules of a complex alloplastic preparation (CAP) based on hydroxyapatite which contains 50-60 wt % collagen. The composite implant also contains either 0.08-2.8 wt % colloidal solution of nanoparticles of zero-valent silver metal Ag0, or gold Au0, or copper Cu0, or palladium Pd0, or platinum Pt0, or 5-12 wt % nanoparticles of said metals in dry form. The nanoparticles have size of 2-40 nm. A colloidal solution of said nanoparticles or colloidal nanoparticles of said metals in dry form is added to the CAP granules. Further, the prepared granules of the gel-like complex alloplastic preparation are laid in a selected ratio on the layer of thrombocyte-rich autoplasma, without mixing, for subsequent transfer into the bone defect space. In case of performing resection of bone fragments in a larger volume until the onset of "pinpoint bleeding", corticotomy is further performed on the cylindrical bone being operated on, with subsequent distraction of the bone regenerate using any existing method. Further, the bone fragments are repositioned, followed by metallo-osteosynthesis. Before wound suturing, the surface of the area with shortage of soft tissue in the projection of the ununited fracture and false joints is covered by a semi-permeable flexible plate made of the complex alloplastic preparation based on hydroxyapatite, which contains 50-60 wt % collagen. The plate has thickness of 0.25-1.2 mm. The surface area of the plate is 10-20% greater than the area with shortage of soft tissue in the corresponding projection. The part of the erythrocyte mass remaining from preparing the thrombocyte-rich autoplasma and the plasma are returned into the bloodstream of the patient by intravenously using a drip during the surgical procedure or in the early post-operation period. After the operation, valtrex is administered to the patient in a dose of 500 gm once a day for two weeks and then in a dose of 500 mg every other day for two weeks.;EFFECT: method provides reliable prevention of OIVI at a damage centre, normalisation of local microcirculation of blood, avoiding ischemic processes, and compensation for the shortening of the length of the limb of the patient being operated on while preventing weakening of the process of reparative osteogenesis and allergic reactions of the body.;6 cl, 4 ex
机译：技术领域本发明涉及医学，尤其涉及创伤外科和骨科，并且可以在缺乏软组织的情况下用于外科手术治疗圆柱状骨的不统一的骨折和假关节。该方法包括在手术前5-6天对来自圆柱状骨损伤中心的骨头和软组织碎片进行穿刺活检，并确定专性细胞内病毒感染（OIVI）的存在和性质。还进行了微血管至毛细血管通道的超选择性血管造影分析。术前2-4天向患者服用Valtrex，每天两次，剂量为500 mg。此外，该方法涉及通过切除骨碎片的端部来进行骨合成或骨再合成，打开骨髓管，骨刺激以及用凝胶状纳米结构复合植入物击打骨缺损的空间。在存在OIVI的情况下，以较大的体积切除骨碎片，直到“针尖出血”开始，即至具有令人满意的骨内血液供应的区域。该复合植入物包含富含血小板的自体质，以1：（1-2）的比例与基于羟基磷灰石的复杂同种异体制剂（CAP）的颗粒混合，该复合物包含50-60 wt％的胶原蛋白。复合植入物还包含0.08-2.8 wt％的零价银金属Ag 0 或金Au 0 或铜Cu 0的纳米粒子的胶体溶液或钯Pd 0 或铂Pt 0 或5-12 wt％的干燥态金属纳米粒子。纳米颗粒的尺寸为2-40nm。将所述纳米颗粒的胶体溶液或干燥形式的所述金属的胶体纳米颗粒添加到CAP颗粒中。此外，将凝胶状复合同种异体制剂的制备的颗粒以选定的比例放置在富含血小板的自体血浆层上，无需混合，随后转移到骨缺损空间中。如果要切除较大体积的骨碎片直到“针尖出血”开始，则对接受手术的圆柱骨进一步进行皮质切开术，随后使用任何现有方法将骨再生。此外，将骨碎片重新定位，然后进行金属骨合成。在伤口缝合之前，用由基于羟基磷灰石的复杂同种异体制剂制成的半渗透性柔性板覆盖未结合的骨折和假关节突出处的软组织不足的区域的表面，其包含50-60 wt％胶原。板的厚度为0.25-1.2mm。板的表面积比相应突出部分中缺乏软组织的区域大10-20％。在手术过程中或手术后早期，通过静脉滴注，将准备好富含血小板的自体血浆和血浆中剩下的部分红血球块返回患者的血液中。手术后，将Valtrex以每天500 gm的剂量给药至患者，持续两周，然后以每隔一天500 mg的剂量给药至患者，持续两周。效果：该方法可在损伤中心可靠地预防OIVI ，使血液局部微循环正常化，避免局部缺血过程，并补偿正在接受手术的患者的四肢长度的缩短，同时防止弱化修复性成骨过程和机体过敏反应。; 6 cl，4前

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