FIELD: medicine.
SUBSTANCE: group of inventions refers to medicine, namely traumatology and thoracic surgery. Anteroinferior, anterolateral and posterolateral fenestrated fractures of 4 to 10 ribs required fixing with a U-splint in the cross direction along the ribs from a paravertabral or scapular line to a mid-clavicular or parasternal line. What is used is a coiled or U-shaped wire splint made of a three-core copper cable in PVC or silicone coating along the ribs on a curvature of patient's hemithorax. The splint is fixed to stable and movable thoracic segments by transcutaneous encircling pericostal ligatures delivered by means of a pericostal guide. The injured thoracic segments are reduced under general anaesthesia with using a mixed anaesthesia with myorelaxants. In females, an upper portion of the splint is positioned directly under a mammary gland slightly displacing it upwards. The lateral floating thoracic segments from the 4-5th to 8-9th rib are fixed by means of the U-shaped splint in the oblique vertical direction from the scapular line to an axillary cavity at an acute angle to the natural course of the ribs, whereas the splint joint is directed in the anterior or superior direction. If the patient suffers multiple rib fractions along several lines in a combination of the anterosuperior with inferolateral and posterior fractures, the chest is stabilised by means of a coiled splint with straight segments of a required length positioned along the fractured ribs or at a blunt angle thereto; the splint is pleated so as to put it along a lower thoracic aperture from below, and make it reach the 3rd rib along the mid-clavicular line, 3rd-4th rib along the mid-axillary line, 5-6th rib along the posterior axillary line, 7th rib along the scapular line and 6-7th rib along the paravertebral line.
EFFECT: group of inventions enables eliminating the risk of postoperative complications.
2 cl, 1 ex
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SU938948A1 |
Authors
Dates
2015-11-27—Published
2013-10-17—Filed