Hauser's surgery

Treatment of diseases: dislocation of the humerus Indication Hauser's surgery is suitable for: Applicable to most patients with mild recurrent hip dislocation, quadriceps and force line are not in line, the two lines of force have an angular deformity to the medial side, no soft tissue around the humerus, no osteoarthritis of the joint Changer. Contraindications 1. It is not suitable for those whose tibial nodules have not yet developed, so as to avoid injury to the epiphysis, and subsequent knee deformity. 2. There are severe knee valgus deformities, and the valgus has not been corrected. Preoperative preparation Use epidural anesthesia, spinal anesthesia or general anesthesia. In the supine position, the thigh is tied to the balloon tourniquet. Surgical procedure 1. Incision: The anterior medial incision of the knee joint was taken, and the incision was stopped at the midline of the distal side of the tibial tuberosity 1.5 cm. The incision flap was retracted to the inner and outer sides to expose the anterior side of the tibia and the ankle. 2. Dislocation and fixation of tibial tuberosity: Cut the sides of the ankle and free the patellofemoral ligament, and cut the patellar ligament to the same square piece of about 1.5cm × 1.5cm from the tibial tuberosity. 3. Cut the lateral soft tissue of the tibia and the joint capsule until the synovial membrane, and then dissipate along the quadriceps tendon to the distal lateral sarcolemma of the lateral femoral muscle. Cut the synovial membrane and explore the knee joint and articular cartilage surface. If there is cartilage wear, it can be flattened with a scalpel. When there is a loose body, it should be removed. After the joint is flushed, the synovial membrane is sutured, and the patellar ligament and the bone block are pulled to the medial aspect of the humerus. , to restore the humerus to the normal position between the femoral condyles, the force line of the quadriceps and tendons in a straight line, the position of the stop point on the tibia, which is selected as the new stop point, in the A bone block of the same size is drilled on the tibia to form a bone groove. 4. The bone block attached to the tendon is then inserted into the bone groove, and the bone block is fixed with a screw of sufficient length to penetrate the contralateral cortex of the tibia, and the patellar ligament is sutured to the surrounding periosteum. The bone piece taken out of the made bone groove is placed in the bone groove of the tibial tuberosity. 5. There are two other ways to make new stagnation points without internal fixation: 1Depalma in Hauser's operation, use a bone chisel to cut a 3cm × 1.5cm with the squat In the shaped bone, a bone groove of the same size as the former is drilled 3 cm inside and below the anterior medial humerus, and the longitudinal axis and the longitudinal axis of the tibia should be at an angle of 45°. After scraping a small amount of cancellous bone with the bone curette at the upper and lower ends of the bone groove, the bone block connecting the iliac crest is placed in the bone groove, and the longitudinal axis of the implanted bone block is rotated by about 45°. Parallel, the bone defect is filled with a bone piece that has been drilled. 2 Another new stop is similar to the Depalma method. The difference lies in the vertical relationship between the longitudinal axis of the new groove and the longitudinal axis of the humerus, and the new bones are connected to the new bone. When the bone groove is stopped, the longitudinal axis of the bone block should be rotated by 90°, placed in the bone groove and then rotated back to the original direction. 6. Suture incision: suture the bilateral joint capsule and aponeurosis, and then suture the incision according to the level.