FIELD: medicine; orthopaedics and traumatology.
SUBSTANCE: reposition fixation apparatus comprises a lever with installed handled reel connected to an arch. In junction of the arch and cable, there is a screw. The other end of the arch contains the other screw fastened of the similar shape and size. The damaged limb segment is fixed at two extreme levels at prescribed distance along the longitudinal axis of the damaged segment. The patient's foot is fixed in foot-holding device of the apparatus. A popliteal support fixes proximal shin. The image converter guided closed apparatus reduction of the fragments follows. The bottom one-third of shin, at the deformation level, the apparatus arch with reduction screws is arranged perpendicularly to longitudinal shin axis. With spooling the cable on the lever with the screw arch fixed on its end, reduction effort is applied percutaneously to the movable end of long bone fragment at level opposite to displacement perpendicularly to said longitudinal axis between two fastening levels to obtain its appropriate anatomic junction with reciprocal bone fragment of the damaged segment. Then the reduction effort application region is fixed so that within the plane of potential displacement of bone fragments there are at least three formed noncollinear combined fixation platforms, with two being located in said fastening levels of the damaged segment, and one found at reduction effort application region to long fragment percutaneously. Residual fragment displacements are eliminated by half-open reposition method. The ensured fragment position is temporarily fixed with the external clamps delivered percutaneously or transosseously. It is followed with stable osteosynthesis of reduced fragments with immersed clamps delivered through the minimal skin incisions. After operation, orthesis is applied on the damaged limb segment providing possibility for early graduated movements in the damaged joint and load.
EFFECT: restored limb function and bone integrity, stable fixation, prevented postoperative complications, reduced injuries and treatment time.
3 dwg
