P.M. Тихилов, А.Ю. Кочиш, В.Л. Разоренов Использование

ÎÐÈÃÈÍÀËÜÍÛÅ ÑÒÀÒÜÈ
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ÈÑÏÎËÜÇÎÂÀÍÈÅ ÎÑÒÐÎÂÊÎÂÛÕ ËÎÑÊÓÒÎÂ ÈÇ ËÀÒÅÐÀËÜÍÎÉ
ØÈÐÎÊÎÉ ÌÛØÖÛ ÁÅÄÐÀ  ËÅ×ÅÍÈÈ ÏÀÖÈÅÍÒÎÂ
Ñ ÃÍÎÉÍÛÌÈ ÎÑËÎÆÍÅÍÈßÌÈ ÏÎÑËÅ ÝÍÄÎÏÐÎÒÅÇÈÐÎÂÀÍÈß
ÒÀÇÎÁÅÄÐÅÍÍÎÃÎ ÑÓÑÒÀÂÀ
Ð.Ì. Òèõèëîâ, À.Þ. Êî÷èø, Â.Ë. Ðàçîðåíîâ
ÔÃÓ «Ðîññèéñêèé íàó÷íî-èññëåäîâàòåëüñêèé èíñòèòóò òðàâìàòîëîãèè
è îðòîïåäèè èì. Ð. Ð. Âðåäåíà Ðîñìåäòåõíîëîãèé»,
äèðåêòîð – ä. ì. í. ïðîôåññîð Ð. Ì. Òèõèëîâ
Ñàíêò-Ïåòåðáóðã
Áëèæàéøèå è îòäàëåííûå ðåçóëüòàòû ëå÷åíèÿ 37 ïàöèåíòîâ ñ îñòåîìèåëèòîì ïðîêñèìàëüíîãî îòäåëà áåäðåííîé êîñòè è îáëàñòè âåðòëóæíîé âïàäèíû, â òîì ÷èñëå 26
áîëüíûõ ñ ãëóáîêîé ïåðèïðîòåçíîé èíôåêöèåé ïîñëå ýíäîïðîòåçèðîâàíèÿ òàçîáåäðåííîãî ñóñòàâà, áûëè ïðîñëåæåíû â ñðîêè îò 6 äî 44 ìåñÿöåâ ïîñëå ïðîâåäåíèÿ îïåðàöèé
ïî ðàçðàáîòàííîé ìåòîäèêå, ïðåäïîëàãàþùåé ðàäèêàëüíóþ
õèðóðãè÷åñêóþ îáðàáîòêó èíôåêöèîííûõ î÷àãîâ è îäíîìîìåíòíîå çàìåùåíèå îáðàçóþùèõñÿ ïîëîñòåé ïîñðåäñòâîì íåñâîáîäíîé ïëàñòèêè îñòðîâêîâûì ëîñêóòîì èç
ëàòåðàëüíîé øèðîêîé ìûøöû áåäðà. Õîðîøèå ðåçóëüòàòû
áûëè äîñòèãíóòû ïðè ñðåäíèõ ñðîêàõ íàáëþäåíèÿ 21,3±9,2
ìåñÿöåâ â 70,6% íàáëþäåíèé, à ðåöèäèâ îñòåîìèåëèòè÷åñêîãî ïðîöåññà áûë îòìå÷åí ëèøü â 5,9% ñëó÷àåâ. Ïðîâåäåííûé àíàëèç ñîáðàííîãî êëèíè÷åñêîãî ìàòåðèàëà ïîçâîëèë óòî÷íèòü ïîêàçàíèÿ è ïðîòèâîïîêàçàíèÿ ê âûïîëíåíèþ ðàññìîòðåííîé îïåðàöèè.
The short-term results of treatment and follow-up in 37
patients with the osteomyelitis of proximal femoral part and
the area of acetabulum including 26 patients with deep
periprosthetic infection after hip replacement were followed
in period from 6 till 44 months after the carrying out of
operations according to worked up technique supposing the
radical surgical debridement of infectious nidi and the singlestage replacement of cavities by means of island flap from lateral
wide hip muscle. Good results were received at the medium
terms of observation 21,3±9,2 months in 70,6% of cases and
the recidivation of osteomyelitis was detected in 5,9%. The
carried out analysis of clinical material allowed to determine
indications for the operation and contraindications to surgery.
Êëþ÷åâûå ñëîâà: ýíäîïðîòåçèðîâàíèå, òàçîáåäðåííûé
ñóñòàâ, îñòåîìèåëèò, ïåðèïðîòåçíàÿ èíôåêöèÿ, íåñâîáîäíàÿ ïëàñòèêà, îñòðîâêîâûé ëîñêóò.
Key words: hip replacement, osteomyelitis, periprosthetic
infection, plastic surgery, island flap.
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Êîíòàêòíàÿ èíôîðìàöèÿ: Êî÷èø Àëåêñàíäð Þðüåâè÷, ä.ì.í.
ïðîôåññîð, çàìåñòèòåëü äèðåêòîðà ïî íàó÷íîé è ó÷åáíîé
ðàáîòå.
ÔÃÓ «ÐÍÈÈÒÎ èì. Ð.Ð. Âðåäåíà Ðîñìåäòåõíîëîãèé»
195427, Ñàíêò-Ïåòåðáóðã, óë. Àêàäåìèêà Áàéêîâà, ä. 8.
E-mail: [email protected]
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