ilium osteotomy

The position of the humerus is superficial, it is convenient to expose and take bone, and the function of the tibia is not important, and a large amount of cancellous bone and cortical bone can be provided. In addition to the poor hardness of the cortical bone and the insufficient internal fixation, the cancellous bone has excellent osteogenesis and healed faster. The tibia can also take bones of various sizes and lengths to meet the special needs of certain operations. In addition, regardless of the position of the patient, the bones for transplantation can be obtained from the tibia. Therefore, the humerus is the most commonly used donor site for bone grafting. Treating diseases: bone damage Indication Regardless of the position of the patient, the bones for transplantation can be obtained from the tibia. Surgical procedure 1. Position: depending on the bone surgery. 2. Incision: Cut along the lower edge of the humerus (ie, between the gluteal muscle and the abdominal muscles, the attachment of the psoas muscle) to the bone. Close to the bone surface for subperiosteal dissection (to avoid insertion of the gluteal muscle to reduce bleeding. Only when the cancellous bone and a small amount of cortical bone, only the gluteal muscle can be peeled off, revealing the outside of the tibia, if you need to take the full thickness of the tibia, then It is also necessary to remove the attachment of the abdominal wall muscles and the diaphragm to the tibia to reveal the inner surface of the tibia. 3. Bone: According to the size and shape of the bone graft, it can be taken in different parts of the humerus. The strips of bone can be cut in parallel with the bone knife. If a thin large piece of cortical bone is required, it can be taken on the outer plate of the humerus. First take the size of the bone according to the plan, gently cut it with a bone knife around, and then gently insert the osteotome between the inner and outer plates to remove it. The wedge-shaped bone can be cut on a full-thick humerus with a bone knife or a chainsaw. The base requires a wide, thick wedge or other leading bone block that can be taken in the first 1/3 or 1/3 of the thicker bone. When the cancellous bone is taken alone, a small incision can be made in the anterior superior iliac spine or the posterior superior iliac spine. The small cortical bone is cut in the anterior and posterior iliac spine, and the curd is inserted into the humerus and the outer plate. After scraping, or cutting off some of the defects, take them between the inner and outer plates. When the bone defect requires a large cancellous bone, it can be cut behind the anterior superior iliac spine with an osteotome between the inner and outer humerus; if cortical bone is required at the same time, the outer plate can be cut together. The blood supply of the tibia is rich, and there are active bleeding on the cut surface. The bone wax can be used to stop bleeding. 4. Stitching: After the bone is taken, the sharp horns left on the tibia should be rounded and flattened to avoid pain caused by postoperative skin irritation. First, the periosteum and the muscle attachment portion are accurately aligned and then sutured, and finally the skin is sutured. 3. Children's tibia is small, and the amount is not much. It is best not to use it. When bone must be taken, the epiphysis should be preserved. The humerus can be cut parallel to the ankle and the iliac crest and the abdominal wall muscles can be turned to the inner side. The outer and inner surfaces of the humerus can be removed, and the bone can be taken on the humerus. . After the bone is taken, the sputum is reset and sutured.

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