METHOD FOR COMBINED OSTEOSYNTHESIS OF INTRAARTICULAR HUMERUS BLOCK FRACTURES USING SUBMERSIBLE COMPRESSION SCREWS AND SWIVEL-DISTRACTION EXTERNAL FIXATION DEVICE

摘要

FIELD: medicine.;SUBSTANCE: wedge osteotomy of the olecranon with mobilization and diverting up of the tendon and the lower third of the shoulder triceps with access to intra-articular fractures of the humerus block. Fracture site reposition is performed, and guide spokes are passed perpendicular to the fracture lines of, along which channels are drilled, and fractures are fixed by introduction of cannulated compression screws into the channels with screw head immersion down the subchondral plate to ensure complete intraosseous location. Then osteosynthesis is performed on the pre-fixed osteotomised olecranon by means of wire and Weber spokes, followed by hemostasis. The surgical wound is sutured by layers tightly to form a bed for the ulnar nerve. Then a modeled hinge-distraction Oganesyan device is imposed on the elbow joint, and spokes are passed through the condyle of the humerus along the motion axis of the elbow joint through the middle third of the humerus, and also through the upper third and middle third of the ulna, along the motion axis of the elbow joint in the frontal plane through the locking fittings of the hinge-distraction device. The spokes are fixed in the hinge-distraction device locks, pulled, and the ends are removed. The hinge-distraction apparatus is fixed by the rear bar with moderate elbow distraction in the average physiological position ensuring the creation of an enlarged joint space. Active development of elbow movements in a hinge-distraction device starts from the third day after surgery. The hinge-distraction device is removed after 4-9 weeks. Removal of wire and spokes locking the olecranon is performed 8-12 months after surgery.;EFFECT: method allows to start early development of operated joint movements, reduces the risk of postoperative contractures and arthrosis.;13 cl