Bone cyst curettage and bone grafting

Suitable for patients with bone cysts. Treating diseases: bone cysts Indication Suitable for patients with bone cysts. Contraindications Pay attention to aseptic operation during operation, reduce the chance of infection, and complete the release of the tendon block with as few cuts as possible, completely loosen the adhesion between the tendon and the tendon sheath without causing unnecessary damage to the tendon and its surrounding tissues. The secondary damage. Preoperative preparation The site of avascular necrosis of the femoral head must be identified before surgery. That is to say, the necrotic lesion is partial or posterior, partial or partial. It can be seen at a glance through CT. This determines the surgical approach, otherwise it will be difficult to reach the lesion area accurately when the lesion is removed. If the lesion is located in the anterior medial aspect of the femoral head, the anterior and posterior approach of the hip should be used as the Smith-petersen incision. If the lesion is located in the posterolateral aspect, the posterior approach of the hip should be used as the Gibson incision. After exposing the hip joint, the switch capsule is cut so as to fully expose the head and neck and achieve the decompression effect in the joint capsule. Open the window at the junction of the head and neck, the diameter is about 1.0 ~ 1.5cm, then use the curette to pass through the hole to completely scrape the necrotic tissue, if necessary, the electric drill or hand drill can be inserted through the tunnel, directly to the subchondral bone, so, The distal intramedullary blood vessels can grow into the periphery of the necrotic area. Finally, the removed autologous tibia is cut into small pieces to fill the scraped cavity and tunnel. The main role of bone grafting is to provide a strong support for the collapsed femoral head to return to its normal shape, thus avoiding fracture complications. During the operation, attention should be paid to the protection of the femoral head cartilage to avoid scratches caused by the instrument. When implanting bone, it is necessary to prevent the bone from falling into the joint capsule and causing the loose body, which affects the joint function. When suturing the joint capsule, it should not be too tight, and a certain gap should be left to achieve the purpose of continuous decompression in the joint capsule. Surgical procedure Male, 45 years old, left distal metacarpal bone swollen for more than 1 year, accompanied by mild pain, hard, non-adhesive to the skin, finger movement free. A longitudinal arc-shaped incision is made across the mass. X-ray films showed that the distal part of the second metacarpal bone was fusiform, the cortical bone became thinner, the inner bone density was reduced, there was no bone texture structure, and there was no calcification. The metacarpophalangeal joint is normal. Use a bone knife to open the window at the enlarged bone, and the contents of the capsule are brown liquid. The cortical bone piece removed from the window is reserved. Thoroughly scrape the inner wall of the capsule and rinse the cyst. A small piece of cortical bone and cancellous bone are taken from the humerus to tightly fill the cystic cavity. , The cortical bone removed from the window is used to cover the cyst window to reduce the chance of postoperative bleeding and adhesion to surrounding tissues such as tendons. Close the wound. X-ray films healed after surgery. complication fracture

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