METHOD OF MINIMALLY INVASIVE BLOCKED OSTEOSYNTHESIS OF PROXIMAL FRACTURES OF FEMUR AND DEVICE FOR ITS IMPLEMENTATION Russian patent published in 2018 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: group of inventions relates to traumatology and orthopedics and can be used for minimally invasive blocking osteosynthesis of proximal fractures of the thigh. At first, the fragments are removed. It is followed by making a transverse incision along the edge of the trochanter about 4 cm in the vestibule with peeling and delamination of the attached ligaments. With the help of a rammer and long scissors a downward supernumerary tunnel of up to 20 cm is created. With its pointed end a plate, which is bent according to the shape of the vertex region, is arranged and fixed to the trochanter through the top opening using a spongy screw, inserted up to the half of its length. With the help of the image intensifier, the lower opening of the plate with a two-level thread is identified, at the level of which a puncture is made. Next, a hollow rod is introduced and screwed into the wide part of the lower opening of the plate. Through the body of the rod, a drill guide is screwed into the opening of the plate, and the bone is drilled. After the passage of both cortical layers, a screw is inserted, if it has been established that the plate is correctly located, it is then tighten. On the upstanding top screw and the hollow rod the template is strung, the position of the holes is marked. Through the opening in the plate, corresponding to the susceptible fossa, at an angle of 130 degrees, the Kirschner's needle is introduced till the neck and further to the edge of the femoral head. Next, an X-ray is made. Then, the optimal position of the fragments is ascertained. After that, the sponge screw in the upper opening is screwed into the plate by its head. Below the location of the needle and below the subtrochanteric fossa, two holes at an angle of 140 degrees are made, defined by the openings of the plate, and two spongy screws are inserted into the openings in parallel. Through the punctures of the soft tissues, the bone is drilled through the distal openings of the plate and the screws are inserted to fix it to the diaphyseal part of the thigh. Then, the wound is closed.

EFFECT: group of inventions allows to provide the minimal access, to simplify the surgery and to ensure the reliability of attachment.

2 cl, 2 dwg, 1 tbl