METHOD FOR OPERATIVE TREATMENT OF MULTI-FRAGMENT FRACTURES OF SURGICAL NECK OF HUMERUS Russian patent published in 2019 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology and orthopedics, and aims at surgical treatment of multi-fragment fractures of surgical neck of humerus. After access to the proximal shoulder, the subscapular, supraspinatus and infraspinatus muscles are sutured at the sites of their attachment to the tubercles of the humerus. Bone fragments of the proximal fragment are reduced by reducing the threads with which the muscles are implanted. Plate with angular stability is located in the area of a greater tubercle of a humeral bone, placing its front edge backwards from intertubercular transverse of a humeral bone, and its top edge – on 5–8 mm below an apex of a greater tubercle humeral bone. Through the holes in the plate, it is fixed by 4–6 spines to the head of the humerus. Two locking screws are inserted through the proximal portion of the plate into the head of the humerus. Rotational displacement of the head of the humerus relative to the diaphysis is eliminated by rotating the plate around the humerus. 2.5 mm diameter drill is used to form a canal in a distal fragment with gripping two cortical layers directed from the outside to the inside in a frontal plane passing through the longitudinal axis of the humerus. Distal fragment is pulled to the plate with cortical screw 3.5 mm in diameter, which is inserted into the formed canal through the proximal portion of the dynamic opening in the plate; the length of the cortical screw is 6–8 mm greater than the length of the canal. That is followed by distraction of fragments on the plate, wherein the cortical screw is loosened. Anterior-posterior projection eliminates displacement of fragments along the length and fixes the screw in the distal section of the dynamic opening of the plate. Then angular displacement of bone fragments is eliminated, for this purpose the cortical screw is re-loosened. In the lateral projection, the angular displacement is eliminated between the proximal and distal fragments and the screw is repeatedly fixed in the distal section of the dynamic opening of the plate. Then, locking screws are installed in distal and proximal fragments. Cortical screw inserted into the distal fragment through the dynamic hole in the plate is replaced with a screw of a smaller length sufficient for fixing a distal fragment in the distal cortical layer. Reduction pins are removed from the proximal fragment. Threads with which the muscles were previously stitched are interconnected or fixed in the holes of the plate.

EFFECT: method provides simultaneous reduction of traumatism, simplification and improvement of reliability of reposition by using a retainer as a "joystick" when eliminating displacement of fragments.

3 cl, 17 dwg, 2 ex