DZHANELIDZE AMPUTATION

From Big Medical Encyclopedia

DZHANELIDZE AMPUTATION ( Yu. Yu. Dzhanelidze , the Soviet surgeon, 1883 — 1950) — osteoplastic amputation of a hip with preservation of an oporosposobnost of a stump. Yu. Yu. Dzhanelidze in 1943 is offered. The free bone transplant forms from the deleted femur.

Technology of operation

the Scheme of osteoplastic amputation of a hip (across Dzhanelidze): at the left — processing of a femur for formation of «lock»; on the right above — the transplant «is got» on the processed femur.

In the lower third of a hip find front and back rags of skin with hypodermic cellulose and a fascia. Muscles of a hip cross on 5 cm distalny the estimated level of section of a bone. Otstupya 5 cm are lower than the planned level of amputation, saw a femur and delete a peripheral part of an extremity. On 7 cm proksimalny the end of a femur, on the front and back surfaces of a bone, a saw do two notches, by depth from each party to 1/3 diameters of a femur. The third notch of the same depth produce on a back surface of a bone, otstupya 5 cm from its lower end. Having put a stump of a hip vertically, a chisel force down a longitudinally cortical layer of a femur from the distal end to the third notch, opening a marrowy cavity. After that at the level of the third notch finally cross a femur, and keep the five-centimetric processed site of a bone (the cylinder with a longitudinal groove) for the subsequent plastics. The remained end of a femur in front and behind to notches is processed a chisel so that «lock» was formed. Get on the end of a femur processed thus a groove the prepared bone transplant and, carefully tapping with the hammer, advance so that its ends acted in the parties on identical distance (fig). In a final look the end of a hip together with a transplant forms a letter «T». The transplant which is put on the end of a femur under some violence thanks to the elasticity keeps very strongly and does not need additional fixing. Put stitches on muscles, a fascia and skin. The Oporosposobnost of a stump of a hip is recovered in 2 — 2,5 months.

The subsequent overseeing by the amputated patients (S.F. Godunov, 1960, 1967) showed that free bone transplants within 2 — 3 years completely resolve or turn into educations like osteophytes and the oporosposobnost of a stump of a hip considerably worsens. And. does not answer



the principles of modern prosthetics (express prosthetics, primary and continuous prosthetics). For these reasons it is applied seldom.

See also Amputation .


Bibliography: Boychev B., Konforti B. and Chokanov To. Operational orthopedics and traumatology, the lane with bolg., page 552, Sofia, 1961; Godunov. T. Ways and technology of amputations, L., 1967; Dzhanelidze Yu. Yu. Collected works, t. 5, page 86, M., 1953; The Multivolume guide to surgery, under the editorship of B. V. Petrovsky, t. 12, page 575, M., 1960.

I. G. Grishin.

Яндекс.Метрика