SURGICAL ACCESS TO THE DISTAL RADIUS OF FRACTURES WITH THE PRESERVATION OF THE MUSCULAR PART OF THE SQUARE PRONATOR

摘要

FIELD: medicine.;SUBSTANCE: invention relates to traumatology and orthopedics and may be applicable for access in intra- and periarticular fractures of the distal radius. Incision is began from the apex of the styloid process of the radius, which is conducted in the proximal direction to the rear portion of the cortical plate of the radius, then rotate at an angle of 45 degrees and conduct a cut proximally to a length of 5–7 cm towards the head of the radius, further bluntly penetrate into the interval between the radial artery and the tendon of the humerus muscle, that the place of attachment of the muscle tendon to the square pronator and the brachial muscle to the lateral margin of the radius are exposed, then, in a sharp way, the tendon part of the muscle is cut off from the square pronator from the lateral edge of the radial bone and subperiosteal dissection is made in the medial direction, that a single full-layer dermal-subcutaneous-fascial-muscular flap containing the median nerve, muscle square pronator and tendons of the flexor muscles of the hand and fingers in their intact synovial vaginas are removed medially. Perform fracture reposition and osteosynthesis with the palmar plate. Conduct refraction of the tendon part of the muscle square pronator to the lateral edge of the radius with capture of the tendon of the brachial muscle by separate non-absorbable nodal seams with an interval of 5 mm each. Suture own fascia of the forearm and skin with separate nodal sutures.;EFFECT: method allows to limit the development of the deficit of rotational movements of the forearm, to ensure the prevention of contractures of the hand and fingers in the early and late postoperative periods.;1 cl, 14 dwg, 1 ex