False joint: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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A false joint is a diagnosis that excludes hopes of cure by conservative methods. Their use in pseudoarthrosis is not justified and only prolongs the already prolonged periods of treatment. In this case, the operation is shown. The main goal of surgical treatment of a false joint is the removal of scar tissue between fragments, the destruction of the sclerotized bone in the area of the closure plates and the contacting parts of the fragments, i.e. The transformation of pseudoarthrosis into a normal fracture. The bone defects that arise as a result of the intervention are replenished by the methods of plastics, which pursue the second goal - the stimulation of osteogenesis. There are quite a lot of various surgical interventions. Some of them have only historical significance, others are used as an independent method of surgical treatment or as a stage in combination with others.
V.M. Arshin proposed the method of elastic automiocompression to eliminate false joints of long tubular bones. Distraction of fragments is carried out on the pin. Next to the fracture site, take an autograft, cut it into two equal parts and insert them between the bone fragments, eliminate the distraction. Due to the elasticity of tissues, autografts are infringed by fragments. After the intervention, the limb is fixed with a plaster bandage.
Currently, a method for the closed treatment of false joints using the compression-distraction method has been developed and widely used. Ilizarov's apparatus is imposed, as in the case of bone fracture. Then, compression is produced, resulting in the destruction and resorption of bone and scar tissue from excessive compression. After the disappearance of the sclerotized areas and the closure plates begin the distraction of the fragments, achieving consolidation and equalization of the length of the damaged segment, respectively, to that of a healthy limb.
With dangling false joints with a defect in the bone, bilocal compression-distraction and osteosynthesis according to G.A. To Ilizarov. Mount the external fixation device of 4 rings, 2 rings above and below the bone defect. Perform an osteotomy between the rings and a gradual distraction of the fragments. Thus, regenerate is grown in the areas of osteotomy, restoring the original bone length, and the compressed ends of the fragments coalesce.
Small bone defects can be eliminated with the help of bone plastic with the use of autonomy, demineralized osteomatrix, homogeneity.
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