Hip joint tuberculosis debridement and joint reconstruction
Hip tuberculosis lesion removal and joint reconstruction are used for surgical treatment of hip tuberculosis. Hip joint tuberculosis can be divided into simple synovial tuberculosis, simple bone tuberculosis, early total joint tuberculosis and advanced total joint tuberculosis. Among them, there are more simple synovial tuberculosis and less bone tuberculosis. After diagnosis, it should be based on patient age. Different treatments are taken for pathological types and different stages of development. Curing disease: Indication Hip tuberculosis lesion removal and joint reconstruction are mainly used for total hip joint tuberculosis with relatively stable lesions. Contraindications Children under the age of 15 generally do not undergo arthrodesis. Surgical procedure 1. Incision and exposure The anterior approach of the hip was used to expose and clear the lesion. In order to facilitate the removal of the iliac bone graft, the upper end of the incision should be slightly extended along the sac. 2. Bone graft fusion joint On the basis of the removal of the lesion, the cartilage surface of the acetabulum and the femoral head is completely removed to expose the bone, but it is necessary to pay attention to maintaining the original shape of the femoral head and the acetabulum, which is beneficial to the extensive contact of the femoral head and the acetabulum. Conducive to integration. The lesion on the femoral head should be completely scraped, but not too much. The cavity can be filled with normal cancellous bone. The wound is then flushed and the femoral head is placed into the acetabulum. In front of the acetabular anterior and femoral trochanter, a bone groove with a width of 3 cm, a length of 7 to 8 cm, and a depth of 1 to 1.5 cm was drilled with a bone. Insert the same size of the humeral bone into the bone groove and fix the bone to the tibia, femoral head and neck with 3 screws or Kirschner wire. 3. Close the wound After the wound was washed with isotonic saline, 1 g of streptomycin was placed in the joint, and the wound was sutured in layers. Fixed with a single-sided hip "human" plaster.
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