patella resection

The tibia can increase strength when stretching the knee and protect the front of the femur and should be retained as much as possible. Only in the case of sacral tumors, severely damaged sacral tuberculosis, comminuted humeral fractures, malunion, articular surface unevenness, and severe patella softening, resection is performed to prevent the occurrence and deterioration of osteoarthritis. The best treatment time: general surgery is recommended to be treated after the initial diagnosis of the disease, special surgery should be prescribed. Treatment of diseases: comminuted fractures and tibia fractures Indication The tibia can increase strength when stretching the knee and protect the front of the femur and should be retained as much as possible. Only in the case of sacral tumors, severely damaged sacral tuberculosis, comminuted humeral fractures, malunion, articular surface unevenness, and severe patella softening, resection is performed to prevent the occurrence and deterioration of osteoarthritis. Contraindications There are no special taboos. Preoperative preparation Psychological guidance Explain to the patient the importance of surgery, introduce the methods of anesthesia, posture, and the way the surgery is done to prepare patients and their families. 2. Systemic condition assessment Preoperative assessment of the patient's general condition, understanding of the patient's past history, past medication and drug allergy history, secondly to understand the patient's physical condition at admission, with or without other diseases. 3. Improve preoperative examinations Including blood routine, urine routine, blood biochemistry and immunological examination. Coagulation and coagulation function tests, electrocardiogram, chest X-ray, X-ray examination, etc. 4, skin preparation (1) Preparation: Remove microbes from the skin, reduce infection, and create good skin conditions for surgery. The preparation range is from 1/3 to the thigh and down to the toe. Be careful not to scratch the skin. (2) Inform the patient to start fasting at 10 pm on the day before surgery and ban water until 6 hours after surgery. If the patient has difficulty falling asleep before surgery, he or she may be given a sedative according to the doctor's advice. 5. Special preoperative exercises, how to use the toilet before the operation, how to urinate on the bed. 6. Other Patients should be instructed to eat high-calorie, high-protein, high-vitamin diets before surgery to increase nutritional supply. Close observation of vital signs before surgery, female patients should pay attention to whether the menstrual period. Surgical procedure 1. Position: supine position, knee straight, place the inflatable tourniquet on the upper part of the stock. 2. Incision: An arcuate incision in the medial aspect of the humerus, or a transverse incision, to open the skin to the sides to reveal the tibia. 3. Excision of the humerus: The quadriceps tendon, the iliac ligament and the anterior humerus of the humerus were longitudinally cut on the 1cm midline of the upper and lower humerus, and the tibia was fixed by clamping the edge of the humerus with a towel clamp. Then, use the tissue clamp to clamp the contralateral aponeurosis cutting edge, and use a sharp knife to close the bone surface for sharp separation until the hemifacial humerus is completely separated; then the other half can be separated in the same way to remove the tibia. Care should be taken not to allow bone debris to leak into the joint cavity during separation. 4. Stitching: suture the patellofemoral ligament and the quadriceps tendon. If there is a fresh comminuted fracture, the person who can not be resected can be retained. The joint capsule has many transverse tears. The quadriceps tendon and the patellar tendon can be sutured up and down to restore the knee extension structure. The suture of the tendon should not be too tight so as not to affect the flexion function of the knee. If the tendon is too short, the quadriceps tendon can be made into a v-shaped incision, or a sacral incision can be extended to repair the defect after the patella resection. complication Meniscus injury Meniscus injury is one of the most common injuries in the knee, more common in young adults, more men than women. The ratio of internal and lateral meniscus injury in foreign countries is 4-5:1, while the domestic report is reversed, the ratio is 1:2.5.