Posterior exposure debridement

The area from the upper outer side of the upper spine to the top of the large ischial notch is generally equivalent to the ankle joint. A pedicled rectangular bone flap (approximately 4 x 3 cm) is usually chiseled between the superior and inferior temporal iliac crests. The bone flap only penetrates the upper, lower and outer sides, and the inner side is not cut open. It is connected with the long iliac ligament of the posterior side to form a pedicled bone flap. When the bone flap is opened, the lesion can be revealed. The curette and the like remove the lesion and remove the exposed articular surface, so that the ankle joint forms a new bone rough surface, and the cancellous bone is filled into the bone cavity to fuse the ankle joint. Treatment of diseases: hip tuberculosis, ankle tuberculosis Indication Applicable to the ankle joint tuberculosis of the humerus and abscess in the buttocks. Contraindications Poor systemic conditions, can not tolerate the operator. Preoperative preparation In addition to the general preoperative preparation of bone and joint tuberculosis, the following points should be noted: 1. If there are oral sinusitis, dental caries and other oral lesions, the operation should be actively treated. 2. Disinfect the mouth with tincture on the 3rd day before surgery, and spray the oral cavity and nasal cavity with antibiotic solution. 3. Systemic application of antibiotics. 4. Skull traction on the day of surgery to stabilize the spinal cord and prevent spinal cord injury. Traction is more important when the atlas is severely damaged, dislocated, or paralyzed. For children or inconvenienced patients with skull traction, the lead gypsum bed should be prepared in advance (the neck is overstretched). Surgical procedure 1. Position, incision, and exposure revealed the ankle joint exposure. 2. The chiseling switch section removes the area from the upper outer side of the upper spine to the top of the large ischial notch of the lesion, which is roughly equivalent to the ankle joint. A pedicled rectangular bone flap (approximately 4 x 3 cm 2 ) is usually chiseled between the superior and inferior temporal iliac crests. The bone flap only penetrates the upper, lower and outer sides, and the inner side is not cut open. It is connected with the long iliac ligament of the posterior side to form a pedicled bone flap. When the bone flap is opened, the lesion can be revealed. The curette and the like remove the lesion and remove the exposed articular surface, so that the ankle joint forms a new bone rough surface, and the cancellous bone is filled into the bone cavity to fuse the ankle joint. Then, rinse the wound with saline. Place 1 g of streptomycin powder and reset the bone flap so that it fits tightly into the bone groove. The gluteus maximus muscle flap was repositioned, the iliac spine fascia was sutured, Finally, the patient is turned to the back and a small oblique incision is made in the lower abdomen to remove the psoas abscess. complication Postoperative infection.