PLASTIC TECHNIQUE FOR ARTHROSCOPIC TREATMENT OF PSEUDARTHROSIS OF NAVICULAR BONE OF HAND Russian patent published in 2021 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used to treat false joints of the scaphoid bone of the hand. After determining the nature of the scaphoid deformity and spatial visualization of the affected bone structures and signs of instability of the ligamentous apparatus of the wrist joint, a pneumatic cuff is applied to the shoulder area of the operated limb and a pressure in the cuff of 310-320 mm Hg is created. The hand is fixed in a traction tower and a traction force of 5-7 kg is created. The midcarpal ulnar port and radial midcarpal port are set. Then, access to the mid-carpal joint is formed. Optics is introduced into the midcarpal ulnar port, a probe is inserted through the radial midcarpal port, and the volume and level of damage to the scaphoid is diagnosed. Next, the pseudarthrosis zone is resected to the level of viable bone tissue, optics are placed in the resection zone, which is inserted through the radial midcarp port to the palmar capsule of the wrist joint at the level of the scaphoid pseudarthrosis resection. Further, additional access to the resection area is performed and the length and intra-scaphoid angle of the scaphoid are corrected. Then antegrade conduction of three pins along the axis of the scaphoid is performed, an EOP control is performed, and a shaft is introduced into the resection zone through the radial midcarpal port. Using a shaft, a fragmented spongy bone graft taken from the contralateral anterior superior iliac spine is placed in the resection area and tamped. The imposition of cutaneous sutures and resection of the needles are performed subcutaneously.

EFFECT: method provides for the correction of the axis and length of the navicular bone of the hand, the correction of dorsal instability of the intermediate fragment of the wrist bones, the absence of damage to the ligamentous apparatus of the wrist joint, the preservation of vascularization and proprioception of the wrist joint, as well as a reduction in the time of surgery, ensuring a sufficient improvement in the patient's quality of life due to the combination of the methods for the claimed inventions.

1 cl, 3 ex