METHOD OF CLOSED ANTI-ROTATION OSTEOTOMY OF FOREARM BONES UNDER THE RIGID PRONATION CONTRACTURES OF FOREARMS IN CHILDREN AND ADOLESCENTS WITH SPASTIC FORMS OF ICP Russian patent published in 2018 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to traumatology and orthopedics and can be used for closed degeneration osteotomy of the forearm bones with rigid pronation contracture of the forearm in children and adolescents with spastic forms of ICP. First cut-down approach is performed in the projection of the distal metaphysis of the radial bone along the anterior-lateral surface up to 0.5 cm longitudinally of the forearm axis. Cortical layer of the metaphysis of the radius is perforated with a bone awl, the size of which corresponds to the diameter of the elastic titanium rod. From the first access, under the X-ray control at 1.5 cm proximal to the presumed level of osteotomy, an elastic titanium rod is introduced, the diameter of which corresponds to the narrowest radiographic dimension of the medullary canal of the radius. Second cut-down approach is made on the dorsomedial surface of the ulnar metadiaphysis up to 0.5 cm. From the second approach, the ulnar perforation is made with the formation of a hole in the cortical layer with a bone awl, the diameter of which corresponds to the elastic titanium rod used. Under X-ray control, an elastic titanium rod is injected to a level of 1.5 cm distal to the prospective osteotomy site. Approach-puncture at the level of the border of the middle and distal third of the radius is carried out. From the resulting approach-puncture, multiple radial bone osteoperforation is performed in various directions in a plane perpendicular to the axis of the radius. Approach-puncture in the projection of the proximal metadiaphysis of the ulna is carried out. Multiple osteoperforation of the ulna in the plane perpendicular to the axis of the bone is performed from the approach obtained. Closed osteoclasis of both forearm bones and a forearm turn into the middle position between supination and pronation is performed. Elastic titanium rods installed in the ulnar and radial bones are led to opposite metaphyses: to the proximal metaphysis of the radius and to the distal metaphysis of the ulna. Cut-down approaches are closed and the forearm is immobilized in the correction position.

EFFECT: method allows to reduce traumatism, to provide reliable fixation.

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