FIELD: medicine; traumatology and orthopedics.
SUBSTANCE: invention can be used for treatment of transcondylar fractures of the humerus in children after unsuccessful closed manual repositions. Reposition is performed in the position of limb flexion in the elbow joint at an angle of 90 degrees. The assistant fixes the limb with his hand in the upper third of the shoulder, with the other hand performs a counter-traction downwards for the middle third of the forearm, and the surgeon, by manual traction, first eliminates the displacement of fragments, performs a skin and soft tissue incision up to 1 cm long from the side of the external epicondyle of the fracture area, along the outer side crest of the distal part of the humerus, without detachment of the periosteum. An index finger is inserted into the incision and, under tactile control, the orientation of fragment rotation is determined. Then it is eliminated. Through the incision, the control of the comparison of the outer sides of the crests of the distal metaphysis of the humerus and the olecranon and the control of the comparison of the inner crests of the humerus are performed. The fragments are fixed with Kirschner wires, cruciformly, through the lower sections of the internal and external condyles of the humerus. The wound is washed with saline, blood clots and bone fragments are removed. Stitches and an aseptic bandage are applied. A plaster splint is applied at the level of the elbow joint, keeping the position of flexion in the elbow joint at an angle of 90 degrees, for 4 weeks.
EFFECT: method makes it possible to perform reposition and stable osteosynthesis of a transcondylar fracture of the humerus while reducing the time of surgical intervention, eliminating the risk of developing complications in the form of cubitus varus, and providing the possibility of early rehabilitation due to the elimination of all types of displacement and the possibility of using the method in case of edema.
1 cl, 4 dwg, 1 ex
