Small incision knee joint adhesion release

Small incision knee joint adhesion lysis is used for the surgical treatment of adhesive knee joints. The most common cause of knee stiffness in the extension is the adhesion of the knee extension device after the femoral injury, that is, the adhesion and shortening of the quadriceps muscle, the adhesion of the ankle, the femoral joint and the ankle support. These adhesions can be removed by a small incision in front of the knee. In some cases, non-uniform adhesion of the femoral, ankle, and posterior capsules can also be separated by an auxiliary small incision. After the operation, the lower limb continuous passive exerciser can be exercised to restore the knee flexion function. Treatment of diseases: knee joint dislocation knee joint meniscus injury Indication Small incision knee joint adhesion lysis is applicable to: 1. The stiffness of the knee joint caused by femoral injury is stiff, and there is no extensive scar on the knee skin. 2. Non-displaced femoral condyle or tibial plateau fracture caused by long-term fixation of knee joint stiffness. Contraindications 1. There have been inflammations such as knee joint purulent infections. 2. Fractures such as the femur or tibia, which are not well healed. 3. Knee soft tissue is widely scarred. Preoperative preparation Sickle knee joint adhesion peeling device 1 patellofemoral joint puncture cone, the tip is triangular, no cutting edge, used to penetrate between the patellofemoral joints, in order to separate the adhesion of the supraorbital sac; 2 curved knife, inner edge with blade Mouth, used to separate the supraorbital sac and quadriceps adhesion; 3 sickle-shaped knife, the inner edge has a cutting edge, used to separate and cut the adhesion of the knee support band; 4 bone knife, long handle scissors and so on. Surgical procedure 1. Make a longitudinal incision of 2 to 3 cm in length 1 cm from the upper shin of the humerus. The medial femoral muscle was separated according to the direction of the incision, and the patellofemoral joint puncture was performed with the patellofemoral joint puncture cone toward the center of the tibia. After the deep humerus was determined, the adhesion was removed. 2. Pull out the puncture cone, insert a curved knife along the injured path, and cut the edge to the proximal end of the femur, and stick the femur to the adhesion of the inner, anterior, lateral and supraorbital capsules of the femur. Since the position of the curved knife can be touched outside the skin of the knee, it can be used as a guide for the incision site. 3. When the finger penetrates into the wound, you can touch the scar that has not been separated and cut it. The bone knife was probed into the wound, guided by external palpation, and the adhesion of the quadriceps to the periosteum of the femur was pushed open until the middle part of the femur, and all the tension strips were separated. 4. The assistant holds the thigh, the surgeon holds the upper end of the humerus, the forearm is close to the calf, and the elbow is placed on the ankle to flex the knee joint with a smooth force. At this point, there is a tear in the joint between the joints. Bend your knees to around 110°. Do not violently bend your knees to avoid a fracture of the tibia. 5. If you still can't flex the knee joint, poke your finger into the wound and touch the tension band of the quadriceps tendon. Use a knife to probe into the wound, and perform a multi-planar incision in the proximal part of the femoral medial and quadriceps tendon attachment points, and select the most intense fiber band to cut it. Often, after a part of the tension band is cut off and the other part is tense, it can be cut in another plane, so that the tension band is cut multiple times in different planes, and then the knee is flexed by the technique, so that the shortened quadriceps can be extended. . If you are still unable to bend your knees, use a pair of scissors and a sickle-shaped knife to plunge into the wound, and cut the support band from the inside of the joint capsule. At this time, the knee can be bent to 90° to 110°. 6. There are many cases of meniscus fractures in the tibial plateau fracture. An oblique incision can be made in the lateral collateral ligament of the knee joint. The switch capsule is cut, the meniscus is exposed, the meniscus is removed, and the knee is adhered. When the knee is bent at this time, the joint is in a hinge-like motion, and there is no sliding movement of the femoral condyle. When the external force is relaxed, the knee joint has a rebounding motion, which proves that there is adhesion of the posterior joint capsule of the knee joint. The oblique incision can be subcutaneously dissected, retracted to the rear, and the switch sac is cut behind the collateral ligament, and the posterior joint adhesion is separated, and the knee is bent to 90° to 110°. 7. Release the tourniquet, pressurize the hemostasis, place the negative pressure drainage tube, and suture the medial femoral muscle and skin. A bandage wraps around the lower end of the femur. complication Fracture Knee joint release, quadriceps formation and small incision release require manual flexion of the knee joint. Before the adhesion is completely loosened, the strong knee bending is easy to cause fracture of the tibia, avulsion of the tibial tuberosity, and even fracture of the femoral condyle. 2. Hematoma Knee joint release and other surgical peeling surfaces are more extensive, and it is advisable to suture the wound after hemostasis. 3. Postoperative knee flexion angle reduction The key to the solution is: 1 completely loose the adhesion during the operation. 2 After the operation, the knee exercise should be adhered to in time. It is not too late to start exercising. It is best to exercise every day for 3 days after the operation. The application of the continuous passive exerciser for the lower limbs is very important and works well. 4. Knee skin splitting If the skin is found to be cracked or exuded, it should be sutured in time and the angle of knee flexion should be reduced.

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