New approaches in surgery for osteomyelitis of the femoral neck and head via anterior access

Bensman V.M.; Savchenko Yu.P.; Malyshko V.V.

doi:https://doi.org/10.17116/hirurgia202106172

Bensman V.M.

Kuban State Medical University

Savchenko Yu.P.

Kuban State Medical University;
Research Institute — Ochapovsky Regional Clinical Hospital No. 1

Malyshko V.V.

Kuban State Medical University

New approaches in surgery for osteomyelitis of the femoral neck and head via anterior access

Authors:

Bensman V.M., Savchenko Yu.P., Malyshko V.V.

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Journal: Pirogov Russian Journal of Surgery. 2021;(6): 72‑77

DOI: 10.17116/hirurgia202106172

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To cite this article:

Bensman VM, Savchenko YuP, Malyshko VV. New approaches in surgery for osteomyelitis of the femoral neck and head via anterior access. Pirogov Russian Journal of Surgery. 2021;(6):72‑77. (In Russ.)
https://doi.org/10.17116/hirurgia202106172

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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OBJECTIVE

To analyze an effectiveness of anterior approach to the hip joint for sequestrectomy with myoplasty.

MATERIAL AND METHODS

We have developed anterior surgical access for osteomyelitis of the femoral neck and head. Semi-oval incision is made in projection of the femoral head. Tendons of sartorius muscle and rectus femoris muscle are cut off from anterior spine of the iliac wing. Surgical field ensures sequestrectomy for osteomyelitis of the hip joint. Closure of osteomyelitis cavity is performed by the proximal parts of two anterior iliacus muscles. Surgical field may be enlarged by temporary intersection of iliopsoas muscle tendon.

RESULTS

The key to anterior surgical approach to the hip joint is sartorius muscle and rectus femoris muscle. The length of surgical wound reaches 17-22 cm, width — 16-18 cm. The mobilized proximal part of sartorius muscle is used for closure of the entire bone cavity in femoral neck and head. Stable long-term remission was observed in 11 (91.7±7.6%) out of 12 patients.

CONCLUSION

Original surgical approach is less traumatic and ensured manipulations under an angle of about 90°. This access complements the advantages of the well-known anterior approaches and has no their disadvantages.

Keywords:

anterior approach

osteomyelitis

femoral neck

myoplasty

Authors:

Bensman V.M.

Kuban State Medical University

Savchenko Yu.P.

Kuban State Medical University;
Research Institute — Ochapovsky Regional Clinical Hospital No. 1

Malyshko V.V.

Kuban State Medical University

Received:

06.07.2020

Accepted:

14.08.2020

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References:

Popkirov S. Gnojno-septicheskaya khirurgiya. Sofiya: Meditsina i fizkul’tura; 1974. (In Russ.).
Selivanov VP, Voronyansky YuP. Osteomielity taza. M.: Meditsina; 1975. (In Russ.).
Gerasimenko MA, Vrublevsky VA, Gerasimov AG, Zhuk YV, Popok SA. Direct anterior approach in total hip arthroplasty: a literature review. Medical Journal. 2018;2:4-7. (In Russ.). Accessed June 19, 2020. https://medmag.bsmu.by/category65/article2898
Chaklin VD. Operativnaya ortopediya. M.: Meditsina; 1961. (In Russ.).
Kornev PG. Khirurgiya kostno-sustavnogo tuberkuleza. M.—L.: Meditsina; 1964. (In Russ.).
Kabanov VN. Comparison of surgical approaches to the hip joint and the search for ways to modernize them from the point of view of clinical morphometry. Bulletin of Higher Educational Institutions. North Caucasus Region. Natural Sciences. 2006;2:106-111. (In Russ.). Accessed June 19, 2020. https://cyberleninka.ru/article/n/sravnenie-hirurgicheskih-dostupov-k-tazobedrennomu-sustavu-i-poisk-putey-ih-modernizatsii-s-tochki-zreniya-klinicheskoy-morfometrii/viewer
Krasovitov VK. Rezektsiya tazobedrennogo sustava. Krasnodar; 1956. (In Russ.).
Linhart WV. Rukovodstvo k operativnoj khirurgii. T. 1, kn. 2. M. 1876:435-439. (In Russ.).
Voino-Yasenetsky VF. Ocherki gnojnoj khirurgii. M.: Medgiz; 1946. (In Russ.).
Gostishchev VK. Operativnaya gnojnaya khirurgiya. M.: Meditsina; 1996. (In Russ.). Accessed June 19, 2020. https://sinref.ru/000_uchebniki/03200medecina/237_operativ-gnojnaya-hirurgiya-gostishchev-1996/001.htm
Nikitin GD, et al. Kostnaya i myshechno-kostnaya plastika pri lechenii khronicheskogo osteomielita i gnojnykh lozhnykh sustavov. SPb: LIG; 2002. (In Russ.).
Prokhorenko VM, Turkov PS. Influence of position of femur proximal part on the choice of quick access. Journal of Siberian Medical Sciences. 2013;3:21. (In Russ.). Accessed June 19, 2020. https://ngmu.ru/cozo/mos/article/text_full.php?id=1007
Hallert O, Li Y, Brismar H, Lindgren U. The direct anterior approach: initial experience of a minimally invasive technique for total hip arthroplasty. Journal of Orthopedic Surgery and Research. 2012;7(1):17. https://doi.org/10.1186/1749-799X-7-17
Bensman VM. Sposob perednego dostupa k tazobedrennomu sustavu. Patent RF na izobretenie №2337629/10.11.08. Byull. №31. (In Russ.). Accessed June 19, 2020. https://www1.fips.ru/iiss/document.xhtml?faces-redirect=true&id=865f7b1b261ed2fe0a889cfb8b5a174c
Bensman VM. Sposob khirurgicheskogo lecheniya khronicheskogo osteomielita shejki, golovki bedra i perednego otdela vertluzhnoj vpadiny. Patent RF na izobretenie №2342908/10.01.09. Byull. №1. (In Russ.). Accessed June 19, 2020. https://www1.fips.ru/iiss/document.xhtml?faces-redirect=true&id=fa3fbdfada435c890986669a06b1e4c7
Corning HK. Rukovodstvo po topograficheskoj anatomii. Berlin: Vrach; 1923. (In Russ.).
Kovanov VV, Travin AA. Khirurgicheskaya anatomiya nizhnikh konechnostej. M.: Medgiz; 1963. (In Russ.).