METHOD OF PRE-OPERATIVE INVASIVE RADIODIAGNOSTICS OF PATHOLOGICAL CHANGES IN HIP JOINT IN CASE OF CONGENITAL HIP DISLOCATION IN CHILDREN FOR FURTHER SELECTION OF METHOD FOR TREATMENT OF THESE PATHOLOGICAL CHANGES

FIELD: medicine.SUBSTANCE: invention relates to medicine, traumatology, orthopedics in pediatrics, rehabilitation. Into cavity of pathologically changed hip joint (HJ) under combined anesthesia introduced is 0.9% sodium chloride solution until tight filling with involuntary 10-20° bending of patient's leg in HJ, 10-15° abduction and external 5-10° rotation. After plain radiography 1.5-5 ml of contrast - 60% urographin are introduced into HJ cavity and forced movements in HJ are performed for contrast to penetrate into all its parts. After that, multispiral computed tomography with 1.2 mm thick axial cuts is performed. On obtained scanograms in frontal plane determined are: degree of femur (F) head dislocation relative to acetabulum (A), A state by cartilage reference points, roof, anterior and posterior edges of A, dimensions of acetabular lip, anterior-posterior and vertical dimensions of A, its depth, indices of its spatial location by angle of vertical A inclination and angle of frontal inclination. Degree of A filling with contrast determined are: presence of fat pad hypertrophy, presence of scar tissues in A projection, deformation of its cartilage edges and acetabular lip, vertical and anterior-posterior dimensions of F head, its form is determined with assessment of deformation degree, spatial orientation of F neck by true neck-shaft angle and anteversion angle, and F condyles must be strictly in frontal plane. State of HJ capsule, state and location of F head ligament, inconsistency between F head and A, volume of A fat pad hypetrophy, presence of scar tissues are estimated. Results are used to determine possibility of closed reposition of F into A or surgical elimination of HJ dislocation by arthrotomy, ablation of scar tissues, straightening acetabular lip with reposition of F head into A.EFFECT: complex estimation of all mentioned indices ensures complete assessment of state of growing cartilage structures of HJ in children, true spatial A orientation, proximal part of hip, reliable detection of anatomical obstacles for reposition of F head into A in order to determine tactics of further treatment.3 cl, 2 ex Изобретение относится к медицине, травматологии, ортопедии в педиатрии, реабилитации. В полость патологически измененного тазобедренного сустава (ТБС) под комбинированным наркозом вводят 0,9% раствор натрия хлорида до тугого наполнения с непроизвольным сгибанием ноги пациента в ТБС на 10-20°, отведением на 10-15° и наружной ротацией на 5-10°