METHOD OF MANUFACTURING INDIVIDUAL PREMODELED ELASTICALLY STRESSED STRUCTURE-FIXATOR AND METHOD OF TREATING INTRA-ARTICULAR FRACTURES OF PROXIMAL AND DISTAL EPIMETAPHYSES OF TIBIA USING INDIVIDUAL PREMODELED ELASTICALLY STRESSED STRUCTURE-FIXATOR Russian patent published in 2023 - IPC A61B17/56 

FIELD: medicine; traumatology; orthopedics.

SUBSTANCE: group of inventions can be used for the treatment of intra-articular fractures of the proximal and distal epi-metaphyses of the tibia using an individual pre-modeled elastically stressed structure-fixator and includes the manufacture of a fixator. The width of the damaged metaepiphysis of the tibia is determined on an x-ray. The length of the working part of the fixator is calculated, taking it equal to 0.8 of the measured value of the width of the damaged metaepiphysis of the tibia. The distance from the plane of the intended location of the working part of the fixator to the plane located 30–40 mm below the distal point of the fracture plane (CD) is determined. The projection of the insertion point and the direction of the fixing screw are determined so that its trajectory is located 25–30 mm below the distal point of the fracture plane. A Kirschner wire is wrapped around a rod with a diameter of 3 or 4 mm so that the center of the resulting loop corresponds to the middle of the wire. The working part of the retaining structure is formed by bending the left and right parts of the wire at a distance of 6–8 mm from the center of the ring in the same plane as the ring. At a distance CD, both ends of the wire are bent at an angle of 120–130 degrees to the axis of the working part, forming an L-shaped bend. Both branches of the structure from the loop to the L-shaped bend are modeled according to the curvature of the surface of the metaepiphysis of the tibia. Using the method of treating intra-articular fractures of the proximal and distal metaepiphyses of the tibia with an individual pre-modeled elastically stressed fixator structure, open or endoscopically assisted reduction of the fracture is performed. In the reduced position, the bone fragments are held with instruments or pre-fixed with pieces of Kirschner wires, parallel to the endplate corresponding to the articular surface, two 1.4–3 mm canals are drilled through the bone fragments, into which the free ends of the prepared fixator are inserted. The loop of the fixator is brought into contact with the cortical layer of the bone and is fixed to it with a 03.5 mm cortical screw. The correct location of the fixator and the quality of reposition are monitored intraoperatively in direct and lateral projections — fluoroscopically in real time or by taking radiographic images. During surgery, the curvature of the structure is corrected.

EFFECT: inventions provide a reduction in the time of surgical intervention and a reduction in the morbidity of the surgical intervention, combined with reliable restoration of the articular surface and the creation of support for the endplate of the articular end by creating a stress-strain state of the fixator, creating compression along the plane of contact of bone fragments.

3 cl, 11 dwg, 2 ex