METHOD FOR TREATING COMPLEX FRACTURES OF PROXIMAL HUMERUS Russian patent published in 2020 - IPC A61B17/58 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology, and can be used for reduction and fixation of fragments in complex fractures of fractures of proximal humerus. Method involves surgical deltopectoral access to the shoulder joint between the deltoid and pectoralis major muscles with skin and subcutaneous fat incision along the deltopectoral sulcus, suturing with single threads of tendons first of the subscapular muscle, then supraspinatus and infraspinatus muscles. Tract of tendon threads with remains of tubercles is dissolved in sides, and a bone allogenic graft is introduced into the marrowy canal, which is a fragment of fibular bone with length of 6–8 cm, including a head having a skewed surface, a neck and a part of the diaphysis, and provided through the entire surface with through channels filled with human-type collagen 1 sponge. Graft introduction into the marrowy canal is performed by diaphyseal part by orienting the skewed surface of the head on the glenoid cavity of scapula so that after reposition the angle between the diaphysis of the humerus and the head of humerus is 130°. Threads with which the tendon of the rotator cuff are sutured are passed through the holes of the osteosynthesis plate of the proximal humerus fractures. Thereafter, under control of fluoroscope, said plate is laid 0.5–1.0 cm distally from apex of greater tubercle posteriorly and parallel to crest of greater tubercle such that angle between plane of articular surface and longitudinal axis of plate corresponds to caput-collum-diaphyseal angle of humerus. Through the central opening in the plate, the head is inserted into the head of the humerus, and the wire is inserted through the ends of all threads drawn through the holes in the plate, while pressing the plate to the proximal humerus; the fragments are repositioned by pulling them on the transplant; thereafter, plate is locked by locked screws while threads ends are locked in plate holes.

EFFECT: method provides strengthening a proximal humerus with reliable reposition by reliable fixation of fragments and using an allogenic graft impregnated with human collagen type 1.

9 cl, 13 dwg, 2 ex