METHOD OF SURGICAL TREATMENT OF COMMINUTED FRACTURE OF PROXIMAL PART OF HUMERUS, CLAMP AND IMPLANT FOR ITS REALISATION Russian patent published in 2010 - IPC A61B17/56 A61B17/68 

FIELD: medicine.

SUBSTANCE: group of inventions relates to field of medicine, in particular to traumatology and orthopedics and can be applied in treatment of patients with comminuted fractures of proximal part of humerus. After removal of small bone fragments into intramedular canal hammered is cylindrical implant from porous titanium nickelide with internal through central canal, semi-cylindrical longitudinal slot on lateral surface and through transversal canal in proximal part of cylinder. Implant is installed in such way that longitudinal slot is located parallel to lateral surface of humerus, and lower opening of transversal canal on anterior surface of implant is located laterally. Head of humerus is put onto protruding end of cylindrical implant. Bone fragments are laid with recovery of form of proximal segment of humerus. Opposite central canal of cylindrical implant and over its semi-cylindrical longitudinal slot in shoulder head, at the level of greater tubercle closer to anatomical neck formed are canals for intramedular legs of first clamp. After that first clamp from alloy with thermomechanical memory is used. Loop-like back of first clamp is made from three differently directed loops, extreme loops are directed with loop down, central one - with loop up. Extreme loops are bent inside clamp in direction to legs, arches are oriented in direction of intramedular legs to each other, intramedular legs diverge. Clamp is cooled. Loops of first clamp are stretched for 10-15 mm and drawn away from legs. One of legs is installed through central canal of cylindrical implant into diaphysis of humerus, second intramedular leg is installed into longitudinal slot on lateral surface of cylindrical implant. Clamp loops are placed above greater and lesser tubercles, enclosing them on perimetre. Holes for upper legs of second and third clamps with S-shaped back from alloy with thermomechanical memory are formed above loops of first clamp, directed downwards, one hole being placed at the level of transversal canal of implant. Holes for lower legs of second and third clamps are drilled in region of distal fragment of humerus. Clamps with S-shaped back are cooled. Bends of back are straightened to increase linear dimension on 10-15 mm. Legs of S-shaped clamps are installed into prepared holes, upper leg of one of S-shaped clamps being introduced into head of humerus through transversal canal of cylindrical implant. Clamp contains loop-like back, passing through arches into intramedular legs. Arches are bent in lateral plane, lying perpendicular to plane of intramedular legs, loop-like back being made from three differently directed loops, extreme loops are directed with loop downwards, central one - with loop upwards. Extreme loops are bent inside clamp in direction towards legs, arches bent in lateral plane are oriented in direction of intramedular legs to each other at 50° angle. Intramedular legs diverge at 15° angle in plane. Clamp is made from alloy with thermomechanical memory of form. Implant from porous titanium nickelide is made in form of cylinder and has internal through central canal, semi-cylindrical longitudinal slot on lateral surface and through transversal canal, located between internal through central canal and semi-cylindrical longitudinal slot, at distance from implant axis equal to radius of internal through central canal.

EFFECT: inventions ensure increase of strength of stabilisation of bone fragments of humerus proximal segment in anatomically correct position, achievement of transversal inter-fragmental compression of bone fragments of greater and lesser tubercles of metadiaphyseal zone of humerus, performing compression in sagittal and frontal planes, elimination of mobility of small splinters in proximal part of humerus, compensation of bone tissue deficiency and reconstruction of destroyed proximal segment of humerus.

1 ex, 3 cl, 13 dwg