METHOD OF OPEN REDUCTION AND FIXATION OF ACETABULAR FRACTURES Russian patent published in 2020 - IPC A61B17/80 G09B23/28 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology and orthopedics, and can be used in methods of open reduction and fixation of shifted acetabular fractures in experiment. Method involves surgical approach, exposing the fragments of an acetabulum, their open reduction with fixation by screws and plates. Corpse is placed on its side; Harding outer-front access to the hip joint is performed, which is used for hip replacement. It involves anterior dislocation of femur. That is followed by femoral neck osteotomy. Hip head is removed, the trochanteric portion of the hip is withdrawn backwards. Further, an acetabular fracture of the B2.2 type according to the AO/ASIF international classification is modeled by osteotomy of the acetabulum with creating column diastase. At the next step, displaced columns of cotyloid cavity approach each other, achieving maximum accurate reposition. At the next stage, after the maximum accurate reposition, the front and back columns of the recess are fixed with spokes; the articular surface of the cotyloid cavity is treated with a milling cutter of the appropriate size until complete removal of the cartilage. That is followed by inserting into the cotyloid cavity of the corresponding cotyloid cavity a reposition-fixing support ring so that the first flange is located above the upper edge of the acetabulum, and the second flange is placed at the junction of the ischial bone and posterior end of the cotyloid cavity, and the third flange is installed on the fusion of the front edge of the cotyloid cavity and the horizontal branch of pubic bone. Then the ring is fixed to the articular surface of the main fragment of the acetabulum linked to the iliac bone by inserting the screws through a group of holes of the support ring within the articular surface of the main fragment of the acetabulum. That is followed by successively introducing one screw at an angle into the rear column through the corresponding hole of the ring and its articular surface and into the front column through the corresponding hole of the ring and its articular surface, leaving part of each screw above the inner surface of the ring. Further, cotyloid recomposition is continued by pulling the columns behind the screws and creating a mutual compression between the main acetabular fragment related to the iliac bone, posterior and anterior acetabular columns, on one side, and creating mutual compression between the main fragment of the cotyloid cavity, posterior and anterior columns of the cotyloid cavity and a ring on the other side. Then, without loosening the tie-rod by the screws, the latter are alternately screwed into the rear and front columns until the head of the screw rests against the edges of the hole of the ring, after which a load is applied on the bones, detecting mobility between the columns and between the columns and the ring. At the next stage screws are introduced into cotyloid cavity columns through all free holes in the ring at different angles, thus strengthening columns fixation to the ring. Then, the ring is additionally fixed to the walls of the acetabulum by inserting screws through the holes of the three flanges.

EFFECT: method provides correct reposition and reliable fixation due to use of fixing support ring, which is attached to cotyloid cavity.

1 cl, 25 dwg