tibia osteotomy

The position of the humerus is superficial, and the front inner side is flat and wide. It is suitable for bone grafting or bone grafting. However, when the tibial bone is not connected, it is best not to take the bone from the contralateral healthy lower extremity to avoid the postoperative complications and affect the healthy limb. The bone can be taken directly from the diseased bone. The advantage of the tibial plate is that it has a hard texture and good internal fixation. It is most suitable for the treatment of bone defects and non-union of fractures. The disadvantage is that the crawling replacement process is slower and the postoperative fixation time is longer. In order to shorten the healing time, cancellous bone transplantation can be performed at the same time. When a small amount of cancellous bone is needed, it can be scraped in the humerus while taking the humerus bone plate, but care should be taken not to damage the epiphysis or articular surface. Treatment of diseases: fractures of the tibial plateau fracture Indication Suitable for the treatment of bone defects and non-union of fractures. Contraindications The age of the body is weak, the vital organs such as the heart and lungs are poor, and the surgery does not restore hope. Preoperative preparation Antibiotics are routinely used before surgery. Surgical procedure 1. Position: In the supine position, the thigh is controlled by an inflatable tourniquet. 2. Incision and exposure: According to the length required for bone grafting, an arc-shaped incision is made in the middle and upper part of the humerus, and the longitudinal edge of the humerus is cut longitudinally, and the two ends are bent inward. It is forbidden to make an incision on the inner surface of the humerus to avoid postoperative pain caused by adhesion of the incision scar to the bone tissue. After the skin was cut, the large skin was slightly separated, the flap was pulled inward, and the periosteum was cut longitudinally for subperiosteal peeling to reveal the anterior aspect of the tibia. 3. Take the bone: You can use the electric saw to take the bone, or you can use the bone knife to take the bone. Before the electric saw is taken, the length and width of the bone should be transplanted according to the plan. The shape of the rectangle should be gently drawn with a bone knife. Then, the surrounding soft tissue is pulled apart, and one hole is drilled in each corner of the rectangle. The saw is sawed from right to left (the saw blade is not easy to enter when going from left to right in the reverse direction). The bone extraction range should not exceed the humeral condyle and the inner posterior edge. Do not saw the saw blade too deep. Do not exceed the four corners of the hole (especially the distal bone hole) to avoid reducing the firmness of the tibia. When sawing, it should be dripped with cold physiological saline frequently to reduce the local high heat, avoid damage to the vitality of the graft bone, and pay attention to prevent sawdust splash and pollution. After the transplanted bone piece is sawn, it is not taken out from the tibia. According to the need of screw fixation, drill 4 to 6 bone holes first, then remove it, and pack it with warm saline gauze. If there is no electric saw, you can use the bone knife to take the bone. First, the rectangular shape of the graft bone was carved on the tibia, and then a row of small holes was drilled in the engraved line. The hole distance was about 1.0 cm, and the bone knife was used to gently cut one by one between the holes. 4. Stitching: The periosteum is firmly sutured together with the deep fascia, and then the skin is sewed. After covering the wound, a bandage is applied from the foot upwards to moderately compress the dressing to reduce bleeding and postoperative edema, and then release the tourniquet. complication Postoperative hematoma. The swelling of the operation should be closely observed within 1 to 2 days after the operation. If it is found that the breathing is difficult and the local hematoma is suspected, the wound should be opened quickly for treatment.