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

FIELD: medicine.

SUBSTANCE: invention relates to traumatology and orthopedics and may be applicable for osteosynthesis in case of fracture of the proximal humerus. Incision of the skin and subcutaneous fatty tissue 5–6 cm long is made between the anterior and middle deltoid muscle bundles from the anterolateral angle of the acromion to the projection of the axillary nerve. Deltoid muscle is spread. Individual strands of the supraspinatus are sewed, subscapular and subscapularis tendons with at least two stitches each, stitching the tendons of the supraspinatus and subscapular muscles 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. Reposition of fragments is carried out by traction over the ends of the threads passed through the tendons, while at the same time a large tubercle is repositioned by tractions in the lateral and distal directions beyond the ends of the threads through the supraspinatus and supine muscles. Then the head of the humerus is rotated by traction in the dorsal direction beyond 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 invasiveness and duration of the intervention, to increase the reliability of reposition, to prevent disruption of the blood supply to the humeral head.

1 cl, 1 ex, 9 dwg