PLATE FOR RIB OSTEOSYNTHESIS AND METHOD OF SURGICAL TREATMENT OF MULTIPLE, FLOATING FENESTRATED RIB FRACTURES USING IT Russian patent published in 2023 - IPC A61B17/80 

FIELD: medicine.

SUBSTANCE: plate for osteosynthesis of the rib contains a longitudinal jumper with transverse clamps extending from the jumper in both directions for bilateral engagement with the rib, and holes along the axis located along the longitudinal axis at the level of the clamps. The contour of the jumper is formed by a continuous connection of circle segments, the centers of which lie on the longitudinal axis of the jumper, at equal distances from each other, and coincide with the centers of the mentioned nine holes, of which there are: a central smooth hole for controlling the installation of the plate along the fracture line, peripheral holes on the ends of the plate with a conical double-start thread, the axes of which are deviated by 55° inwards relative to the axis of the plate, and the remaining holes are vertical, with a conical double-start thread, while the holes with a conical double-start thread are intended for fastening, bone, self-tapping screws, with conical heads having a conical double-start thread, and a slot at the end of the head. Plate width is 10 mm, thickness is 1.5 mm. The jumper is made with a transverse bend, the radius of which is equal to the length of the plate; pairs of transverse clamps 1 mm thick are located at the penultimate holes at each end of the jumper. The plate allows for low-traumatic and stable fixation of rib fragments with preliminary reposition in order to eliminate the pathological flotation of their broken segments, to stabilize the frame function of the chest wall in full and ensure patient mobility. The method of surgical treatment of multiple, floating fenestrated fractures of the ribs using the above plate is performed as follows: before the operation, computed tomography sections of the chest wall are analyzed, including using 3D reconstruction, to determine the location of fractures, the number of ribs, to carry out stabilization and the length of the fastening, bone, self-tapping screws. Through a small incision in the projection of the fracture, the muscles are bluntly moved apart along the muscle fibers, without peeling off the periosteum and costal pleura, the rib fragments are mobilized, the rib fragments are repositioned using bone clamps, the plate is bent to be adapted to the shape of the rib, placed along the rib using the central smooth hole, the installation along the fracture line is controlled and it is fixed in the intercostal muscles with transverse clamps. Mounting self-tapping screws with conical heads having a conical double thread are inserted into the peripheral holes at the ends of the plate; self-tapping screws with conical heads having a conical double thread are inserted into the vertical holes of the plate. The manipulation is repeated over each fracture. The wound is sutured tightly, rubber graduates are installed.

EFFECT: method ensures a reduction in the morbidity of surgical treatment of multiple, floating, fenestrated rib fractures while increasing the efficiency of restoration of the rib frame and its biomechanical integrity due to stable fixation of the rib fracture in a shorter period of time and the creation of optimal conditions for reparative regeneration and rapid healing of the fracture.

2 cl, 5 dwg