METHOD FOR CLOSED REDUCTION OF RADIAL SHAFT FRACTURES WITH OSTEOSYNTHESIS USING BUNDLE OF TENSION PINS Russian patent published in 2015 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: method involves following all the stages of a closed reduction of radial shaft fractures with a patient lying on an electrooptically controlled surgical table. The procedure starts with specifying an adduction-type or abduction-type radial fracture and detecting a lateral or medial misalignment of the radial shaft; a muscular relaxation process is followed by needling the skin at 3-4 mm along the lateral surface of the radial bone with creating a trephine opening of 3.0-3.5 mm in diameter in the distal epiphyseal cartilage of the radial bone 5-7 mm below the styloid process. The first tension retainer pin of 2 mm in diameter is inserted through the opening into the intramedullary canal and stopped 2-3 mm short of the radial shaft fracture line; a bent styloid hook is inserted through the needled skin at the level of the radial shaft fracture between the fragments to perform the transcutaneous reduction of the bone fragments of the radial shaft fracture. The first tension pin is inserted into the proximal fragment of the radial bone at a depth of 3 or 4 diameters of the intramedullary canal; the bent styloid hook is removed from the radial shaft fracture space with eliminating rotational and angular misalignments of the bone fragments; an X-ray imaging check-up follows. Thereafter, 3-5 tension retainer pins are inserted additionally into the intramedullary canal of the radial bone in parallel with the first one until the intramedullary canal is completely full; the pin ends are bent off and immersed into the skin. The surgical procedure is completed by applying one skin suture in the point where the tension retainer pins have been inserted, which is followed by antibacterial therapy for 4 or 5 days. On the first or second postoperative day, the X-ray imaging check-up is required to image the patient's operated forearm bones in two standard projections covering wrist and elbow joints. The postoperative patient management involves an active development of the wrist and elbow joints 2 or 3 days after posttraumatic pain syndrome has been relieved; the above development involves doing exercises 3-4 times a day until functions of the operated upper limb are completely recovered. Another X-ray imaging check-up is required in 4 weeks after the operation to determine if the total functional load is possible and in 8 weeks after the operation to settle the day of the retainer pins removal that is ensured in 10-12 weeks after the operation in the outpatient settings under local anaesthesia if observing the complete fracture consolidation. The flexible tension retainer pins are presented by the Ten rods or Ender's nails. The retainer pins are made of biologically inert materials, e.g. titanium, titanium alloys or surgical stainless steel.

EFFECT: method enables providing the stable functional fracture osteosynthesis in the patients of all ages, eliminating the risk of angular misalignments of the radial fragments, reducing the risk of inflammatory complications considerably, providing a possibility of the total functional load on the patient's limb, reducing the length of the complete functional recovery of the patient's limb.

3 cl, 5 dwg, 3 ex