Prothese totale de hanche

  

technique operatoire : PTH

CHIRURGIEN

 

IBODE

Incision Cutanée postéro externe

 

Bistouri froid lame n°20

compresses

Incision du fascia latta et du muscle grand fessier

 

Bistouri froid profond lame n°20

Ecarteurs de farabeuf

Désinsertion des muscles pelvi-trochantériens

 

Bistouri électrique.

Pince à disséquer multi griffes

Cadre de Charnley

Ecarteurs américains

 

Ligature de l’artère circonflexe

Angle droit

 Vicryl 2 bobine

Pinces de Halstead à garder

 

Section au ras du trochanter du tendon pelvi-trochantérien

Bistouri électrique

 Pince à disséquer multi griffes

Ouverture de la capsule en 2 volets

 

Vicryl 2 48mm sur porte-aiguille

Pince à disséquer multi griffes

 2 pinces à garder

Ciseaux de Mayo courbes

 

                                           ABLATION DE LA TETE FEMORALE  

Luxation de la tête fémorale par des mouvements de flexion abduction et rotation interne

 

Ecarteur de Hohmann

Ecarteur moyen fessier

 

Section du col fémoral

 

Scie de Muller

Lame de Pauwels n°25

Maillet

Bistouri froid lame n° 20

Extraction de la tête fémorale, section du ligament rond, hémostase

Pince de museux ou Bicher

Conservation de la tête dans cupule recouverte par compresse humide

TEMPS FEMORAL

Agrandissement du fût

Tarière de Muller

Alésage du canal médullaire

 

Râpes fémorales (taille START à  5)

Barre de retrait

Maillet

 

Récupère os spongieux

 

Curette crantée longue

 

Essai fémoral

 

Essai fémoral

Impacteur demi lune

Maillet

 

Nettoyage du fût

 

Sérum physiologique dans seringue

60cc

Pince de Bengoléa +compresse

 

TEMPS COTYLOIDIEN

Nettoyage du fond du cotyle et du rebord cotyloïdien

 

Bistouri froid lame longue

Multi griffes

Ciseaux gouge fin

Maillet

Pince gouge

Alésage du cartilage cotyloïdien jusqu’à l’os sous chondral

Fraises (44 a 3) montées sur moteur équipé de l’embout pour alésage

Fraises utilisée dans cupule avec sérum

Nettoyage du cotyle

Curette crantée

Essais de même taille que la dernière fraise utilisée

 

Porte cotyle

Cupule à bord plat ou normal

 

CHANGE DE GANT

 

IMPLANTATION DE LA TIGE FEMORALE DU COL ET DE LA TETE

Ablation de la compresse laissée dans le fût

Pince à disséquer multi griffes

Essai

Prothèse fémorale d’essai       

lmpacteur

Maillet

Col d’essai (3 tailles court, moyen, long)

 Impacteur pour la tête

Réduction, test de longueur de jambe, stabilité et mobilité

 

Luxation

Crochet de Lambotte

Ablation prothèses d’essai

Extracteur de prothèse Maillet

Changement de gants et rinçage

Changement de gants

Seringue 60cc sérum

Col, tête et tige définitifs

Prothèses définitives

Impacteur de tête (impacte la tête dans la cupule)

 Maillet

FERMETURE

Changement de gants

Changement de gants

Suture de la capsule

Vicryl 2  48mm sur porte-aiguille

Pince à disséquer

Ciseaux de Mayo

 

Réinsertion des muscles

 

Pinces à disséquer multi griffes longues

Drain de Redon sur alêne

 

Suture du tissu cellulaire sous cutané

Vicryl 1 48 sur porte-aiguille

pince à disséquer        

Ciseaux de Mayo

 

Antisepsie des berges cutanées

griffes

Compresses    

Suture cutanée

Agrafes

Fixation du drain de Redon

Vicryl 2 48mm

 Raccorder le flacon de Redon 

Pansement

  

 

Commentaires (1)

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