METHOD OF OSTEOSYNTHESIS IN THE FRACTURE OF THE PROXIMAL HUMERUS Russian patent published in 2018 - IPC A61B17/58 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and may be applicable to osteosynthesis for fractures of the proximal humerus. Deltoid muscle is spread. Access to the tendon of the long biceps head, located in the inter-hill groove of the humerus, and hem it to the proximal edge of the tendon of the pectoralis major muscle at the place of its attachment to the humerus. Tenotomy of the tendon of the long bicep head at the point of attachment to the articular cavity of the scapula is performed, and its free end is cut off by 0.5–1 cm proximal to the superimposed tendon suture. Sew the individual strands of the supraspinatus, supraspinatus and subscapularis tendons with at least two stitches, each, and the supraspinatus and supine tendon tendons are stitched at a distance of 1–1.5 cm from their attachment to the large tubercle of the humerus, and the tendon of the subscapularis muscle – at a distance of 1–1.5 cm from the place of its attachment to the small tubercle of the humerus. Carry out the reposition of fragments by traction for the ends of the threads passed through the tendons. First, a large tubercle is repositioned by traction in the lateral and distal directions for the ends of the filaments through the supraspinatus and supine muscles. Then the head of the humerus is rotated by traction in the dorsal direction at the ends of the filament through the tendon of the subscapularis muscle. Keeping the thread behind, they perform a longitudinal incision with a length of 1–1.5 cm of the supraspinatus tendon, through which an inlet hole for the pin is formed in the head of the humerus. After insertion of the pin, it is fixed with the help of locking screws through the pin holes, the proximal locking screws being guided through the large and small tubercles of the humerus, and the distal locking screw through the diaphysis of the humerus. To the caps of the screws, they fix with a tension held through the tendons of the thread, while to the screws located in the region of the large tubercle of the humerus, fix the thread, held through the tendons of the supraspinatus and supine muscles, and the screw, held through the small tubercle of the humerus, fix the thread, held through the tendon of the subscapularis muscle.

EFFECT: method allows to reduce the trauma, improve the reliability of reposition, to prevent disruption of the blood supply to the humeral head.

1 cl, 11 dwg, 1 ex