METHOD FOR ELIMINATING THE PRONATION CONTRACTURE OF THE JOINTS OF THE FOREARM IN PATIENTS WITH CEREBRAL PALSY

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and may be applicable to the elimination of pronation contracture of the joints of the forearm in patients with cerebral palsy. Medial access to the muscle of the quadratrum is performed. Tomium of the square pronator along the axis of the ulna and transversely to the muscle fibers is performed. Square pronator is exfoliated from the radial bone all over. Tendons of the ulnar flexor of the hand are isolated. Tendon of the ulnar flexor of the hand is stitched with a thread in the place of its distal attachment, a tenotomy of a tendon of the ulnar flexor of a hand is performed. Ends of the thread are held with a holder. Lateral access to the lower third of the radial bone is provided. Lower third of the radius is exposed layer-by-layer. Tendons of the long muscle extending the thumb, muscles of the short extensor of the thumb, and brachio-ureteral muscle are isolated. In the interval between the tendon of the brachiocephalic muscle and the tendons of the long muscle, extending the thumb, and the muscles of the short extensor, the space for attaching the tendon of the muscles of the ulnar flexor of the hand is formed in subperiosteal way. Through channel in the radial bone is made in the anteroposterior direction. Tendon of the ulnar flexor of the hand is pulled with the thread, bending around the radial bone, and conducted into the canal in the direction from front to back. Distal end of the tendon is removed from the canal. Forearm and hand are attached to the position of the maximum possible supination, by adjusting the degree of tension of the tendon of the ulnar flexor of the hand by pulling the thread. Tendon of the ulnar flexor of the hand is looped around the radius and its distal end is stitched to its free proximal part. Part of the tendon of the ulnar flexor of the hand, looped around the radial bone, is stitched to the distal section of the brachio-ureteral muscle, in the place of its fixation to the bone. Wounds are closed. Immobilization of the limb is performed.;EFFECT: method allows to reduce the injury scope and provide active supination.;6 cl, 5 dwg, 1 ex