SET OF DEVICES AND METHOD OF TREATING UNILATERAL PUBIC BONE FRACTURE WITH ACCOMPANYING SYMPHYSIS RUPTURE Russian patent published in 2025 - IPC A61B17/80 A61B17/68 

FIELD: medicine.

SUBSTANCE: set of devices for treating unilateral fracture upper branch of pubic bone with accompanying symphysis rupture includes nail for fixation of fracture of upper branch of pubic bone of the pelvis, plate for fixation of symphysis rupture and screws. Nail for fixation of fracture of upper branch of pubic bone of the pelvis contains two transverse holes for installation of screws. Plate for fixation of rupture of symphysis is made with possibility of installation on upper branches of pubic bones of pelvis above symphysis and represents flattened C-shaped part containing two arms located symmetrically relative to perpendicular transverse plane passing through centre of plate, where each arm is provided with a pair of holes for screws, wherein the angle α formed by axes drawn through the centres of each pair of holes ranges from 100 to 120 degrees, inclusive; and a hole for a locating, temporary fixing pin. Distance between the screw holes in the plate corresponds to the distance between the screw holes in the nail. Screws are made with possibility of passing through holes of nail and plate. Method of treating a unilateral fracture of the superior branch of the pubic bone with a concomitant rupture of the symphysis using the above set of devices is characterized by the fact that at the first stage, a surgical suprapubic open approach is performed with subsequent inspection of the pubic symphysis rupture zone and elimination of the detected diastasis with the help of reposition pelvic forceps, at the second stage, the fracture of the upper branch of the pubic bone is fixed with a locking nail from the above set, comprising two transverse holes for the installation of screws, at the third stage, the above set of the plate for fixation of the symphysis rupture is installed, with placement of its holes in the projection of the nail holes, with the subsequent locking of the nail with screws from the above set, which are passed through the plate holes. For fixation of fracture of upper branch of pubic bone with locking nail at the second stage under X-ray control of C-arm, guide pin is delivered through external angle of pubic bone body bottom-up and front-back towards cotyloid cavity along its upper branch intraosseously with provision of internal cortical wall preservation. Anterior cortical wall of the pubic bone is drilled along the guide pin with a cannulated drill. Pin and the drill are taken out, and through the performed surgical approach from the side of the intact half of the pelvis, a nail preliminarily fixed in the guide is inserted intraosseously until its proximal part is completely immersed in the bone canal. Further, the plate is installed at the third stage without removing the guide from the installed nail. Plate is laid along the upper surface of the pubic articulation so that its middle is in the middle of the matched pubic symphysis. Plate is temporarily fixed with a pin from the above set through a corresponding hole. Drill cannulas are inserted into the transverse guide holes of the conductor, which are then matched with the holes in the plate of the first arm, and under the control of the C-arc, the nail is locked by two screws, which are passed through the holes of the first arm of the plate, starting from the hole located closer to the pubic symphysis. Thereafter, the guide is detached and removed from the incisional wound. Then the second arm of the plate is fixed in the opposite pubic bone.

EFFECT: increasing the effectiveness of treatment while reducing surgical injuries.

17 cl, 12 dwg, 1 tbl, 1 ex