METHOD OF MINIMALLY INVASIVE SURGICAL TREATMENT OF FRACTURES OF THE ANTERIOR PELVIC SEMI-RING BONES Russian patent published in 2018 - IPC A61B17/58 

FIELD: medicine.

SUBSTANCE: invention relates to traumatology and orthopedics and can be used for minimally invasive surgical treatment of fractures of the anterior pelvic semi-ring bones. Conductor and fixing plates corresponding to the fracture of the left or right half of the anterior pelvic semi-ring are used. Conductor is made in the form of upper and lower tubes, which are fixed in parallel by one ends in the body, wherein the upper tube is nondetachable fixed, and the lower tube is fixed by screws, wherein end-faces of the other ends of both tubes are cut by a plane inclined to their axes at an angle of 45°, internal diameters of the upper and lower tubes are not less than the dimensions of the heads of self-tapping takedown screws of the fixing plate to the bone and the outer diameter of the detachable adapters for a drill or pin with the possibility of their sliding, wherein the other end of the lower tube is in the form of a collet clamp having a movable collet lock covering collet legs and a sectional U-shaped grip, which are divided in two by a plane along the axis of the lower tube and are configured to grip and hold the fixing plate having two oval holes along its axis with an interaxial distance equal to the distance between the axes of the upper and lower tubes, wherein the fixing plate has two blind holes on its proximal portion corresponding to the protrusions formed on the sections of the U-shaped grip, means for separating the collet legs of the U-shaped grip is made in the form of a weakened section of each leg at the point of their bend by means of a transverse curved groove on its outer surface and lateral bevels with through holes, adapted to angularly move the legs from the closed position to an angle α, providing disengagement of the protrusions of U-shaped grip with holes on the fixing plate, wherein an annular groove is formed inside the legs when they are closed in the zone of the U-shaped grip, an elastic element is arranged in the annular groove in the form of a split ring with the possibility of elastic movement of the legs, wherein the said inclined cutting plane of the upper tube coincides with the inner surface of the U-shaped grip of the collet clamp, which is adapted to freely axially move the head of the self-tapping screw through it, collet lock is equipped with a spring-loaded ball, conjugated with a circular groove on the conductor tube when fixing the metal implant with the U-shaped grip, wherein one of the sections of the U-shaped grip is provided with a bone limiter configured to provide a working position of the conductor relative to the upper edge of the anterior pelvic semi-ring. Fixing plate is periosteally guided to the inside of the pelvic cavity with the conductor, sliding the bone limiter along the terminalis line until it coincides with the proximal acetabular margin and the middle of the distal part of the fixing plate coincides with the middle of the pubic symphysis along the inlet view. Through the detachable adapter in one of the two tubes, a temporary fixation of said fixing plate is made with a pin with a diameter of 2.5 mm and the final intraoperative x-ray control of the position of the fixing plate relative to the anterior pelvic semi-ring is carried out. Fixing plate is bent under the anatomy of the anterior pelvic semi-ring at an angle of 90° between the parts of the fixing plate, wherein the distal part of the fixing plate is made in the form of an arc with the arrangement of two groups of fixing holes in threes in a group with two pairs of weakened sections between them along the arc. Bone limiter is placed on the upper plane of the damaged pubic bone under the EOC control. Channel is formed by the drill in the bone through the hole in the distal part of the fixing plate at a predetermined angle of 45° relative to the latter. Drill and detachable adapter are removed from the tube through which a 3.5 mm self-tapping screw is threaded into the hole of the fixing plate with a screwdriver, then the distal end of the plate is fixed through one of the holes, which are closer to the pubic symphysis with a 3.5 mm self-tapping screw of the appropriate length through the body to the lower branch of the pubic bone after the preliminary formation of the hole by a 2.5 mm drill by using the "free arm" surgical technique. Fixing pin is further removed from the detachable tube adapter and a hole is formed in the bone through the same adapter with the drill at a specified angle of 45° relative to the fixing plate. Distal part of the fixing plate is fixed by self-tapping screws through the remaining holes at least two screws in each pubic bone. Fixing plate is released from the conductor, which is removed from the surgical wound.

EFFECT: method allows simplifying the surgery, reducing the injuries.

1 cl, 17 dwg