FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to traumatology and orthopaedics, and can be used for fixation of detachable bone fragment of nail phalanx in case of closed injuries of terminal part of finger extensor mechanism. Method involves a shaped Z-shaped approach along a dorsal surface of a distal interphalangeal joint and a ligature around a detachable bone fragment of the nail phalanx. Conductor is inserted in the region of the base of the bone phalanx from the palmar surface and delivered through the soft tissues of the nail phalanx along the bone, leading the end of the conductor to the dorsal surface of the distal interphalangeal joint through the extensor mechanism. Non-absorbable ligature is pulled from the edge of the terminal part of the extensor mechanism by 1/3 of its width, and then a non-absorbable ligature is brought out from the dorsal surface to the palmar surface, followed by removal of the guide wire. Guide wire is inserted on the palmar surface of the nail phalanx from the opposite side of the brought-out end of the ligature and directed parallel to the distal interphalangeal joint, it is passed along the palmar surface along the bone of the nail phalanx through the soft tissues and bring the end of the guide wire to the place of the previous exit of the ligature. Inside the guide wire, the previously brought out end of the ligature is brought to the opposite side and the guide wire is removed. On the dorsal surface of the DIPJ, the guide wire is introduced through the extensor mechanism at 1/3 of its width from the edge of the terminal part of the extensor mechanism and delivered along the bone of the nail phalanx through soft tissues, and its end is brought out to the place of the previous ligature exit on the palmar surface. Inside it, an end of the ligature is delivered onto the dorsal surface with further removal of the conductor, thus wrapping the ligature around the bone nail phalanx and placing both ends of the ligature along the dorsal surface in the region of the distal interphalangeal joint. Transarticular fixation of the distal interphalangeal joint is carried out with a pin in a neutral position, an open reduction of the avulsion fracture of the nail phalanx is performed, and the detachable fragment is fixed by tightening the ligature knot proximal to the bone fragment.
EFFECT: method provides anatomical reduction and stability, eliminates deformation and formation of contracture of distal interphalangeal joint by preventing displacement of detachable fragment.
1 cl, 7 dwg, 1 ex
