METHOD OF MINIMAL INVASIVE OSTEOSYNTHESIS IN MULTIFRAGMENTAL FRACTURES OF THE DISTAL FEMUR Russian patent published in 2018 - IPC A61B17/58 

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, namely to traumatology and orthopedics, and is intended for use in the treatment of patients with multifragmental fractures of the distal femur. Perform reposition of bone fragments with their subsequent fixation by two plates with angular stability of the screws, which are set epiperiosteally on the lateral and medial sides of the femur. In this case, after performing osteosynthesis with the plate from the lateral side of the femur, perform plate modelling to install on the medial side, using a commensurate model of the femur and choosing the length of the plate, taking into account the sufficiency for overlapping the fracture zone. Then, a distal incision of 4–5 cm in length is made on the medial surface of the femur along a line 2 cm anterior to the projection line of the femoral artery, starting from the level of the lower edge of the medial epicondyle of the femur and continuing in the proximal direction. Then the modeled plate is drawn from below upwards to the anterior medial surface of the femur in the direction of the superior anterior iliac spine until the distal end of it reaches the lower edge of the incision. Then the proximal end of the drawn plate is palpated and above it a proximal incision is made 4–6 cm long along a line parallel to the projection to the skin of the femoral artery and spaced 2 cm anterior to it. Further, in the wound, visualize the space between the rectus thigh muscle and the medial vastus muscle, dissect and divorce the soft tissues in it. Then pass between the medial and the intermediate vastus muscles, the femur is exposed and the proximal end of the inserted plate is found. Then, through the proximal incision, a retractor is inserted under the relief surface of femur to prevent damage to the major hip vessels when guiding the screws and fixing the plate with screws through both accesses distal and proximal to the fracture zone.

EFFECT: method allows to increase the stability of fixation of bone fragments, provides fixation of intermediate bone fragments in the fracture zone, as well as to exclude the risk of damage to the major blood vessels of the hip.

1 cl, 18 dwg, 1 ex