| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention relates to field of medicine, namely to traumatology and orthopedics, and can be applied in treatment of severe scolioses with correction of concave deformity of chest. Method includes carrying out, with patient in position on abdomen, of a skin cut above spinous processes from Th1 to L5 vertebra, layer-by-layer dissection of subcutaneous cellular tissue, fascia, correction of scoliotic deformation of spine by means of instruments Cotrel-Dubousset with fixation of spine, laying on posterior elements of spine autransplants from resected spinous and articular processes, suturing the wound and de-assembling of halo-apparatus. After skeleting posterior elements of spine from two sides, first additional mobilisation of spine by tenoligamentocapsulotomy is made. After that, subcostally from the same access ribs on concave side of chest are skeleted. Above rib-transversal joint osteotomy of five-six ribs is performed without injuring neuro-vascular bundle and parietal pleura. Area of osteotomated ribs is tamponed with wet tissue with physiological solution. After carrying out correction and fixation of spine with application of Cotrel-Dubousset instruments, halo-pelvic traction is removed and decortication of vertebra arches, resection of articular processes and elevation of osteotomated ribs on the rod of metal structure are carried out. By means of laminectomes on transected ribs cuts are made and ribs are fixed to the rod of metal construction and to spinous processes with application of wide tape from nonabsorbable lavsan. After that, on posterior elements of spine laid are autotransplant in form of resected spinous and articular processes and granules of macroporous bicalcium phosphate. ^ EFFECT: application of claimed invention makes it possible to reliably eliminate deformation of patient's chest on concave side, achieve simultaneous elimination of spine deformation, ensure preservation of initial correction of spine deformity, ensure elimination of patient's chest deformation with prevention of development of pulmonary-cardiac failure, as well as to ensure early social rehabilitation and increase patient's life quality. ^ 1 ex, 5 dwg |
