METHOD FOR CLOSED REDUCTION OF FRACTURES OF SURGICAL NECK OF HUMERUS WITH OSTEOSYNTHESIS WITH STRAINED NAIL BUNDLE

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely traumatology and orthopaedics and is intended for a closed reduction of fractures of the surgical neck of the humerus. A patient is anaesthetised. A kind of an adduction fracture of the surgical neck of the humerus, as well as a lateral or medial dislocation of the humeral diaphysis is determined. The dislocation is typed if observing the humeral dislocation in a combination with the fracture. Preliminary myorelaxation is followed by manual or countertraction reposition of the detached head into the humeral joint to evaluate a relation of the head of the humerus to the distal portion of the humerus under electronic-optical control. The curved cannulated awl inserted through a 3-4 mm skin incision along the external posterior surface of the lateral condyle of the humerus is used to form the condylar canal towards the bone marrow canal of the humerus. A strained fixation nail is inserted into the bone marrow canal of the humerus through the formed canal and through the formed skin punctures along the inferior-exterior posterior surface of the external condyle of the humerus outside of the elbow joint to the fracture line. Each individual fixation nail of 2 mm in diameter is inserted by rotation. Ten rods and Ender rods in a quantity of 5 to 8 are used as the strained flexible fixation nails. The required quantity of the strained fixation nails is inserted to form a nail bundle. That involves using the fixation nails with the ends bent at an angle of 25-30°C at 30-40 mm from a sharp edge. The bent ends of the fixation nails inserted to the fracture line are turned in opposite directions to form a fan of the strained nails. A percutaneous reposition device is inserted through the skin puncture between the fragments and used to eliminate the edgewise dislocation of the diaphysis, as well as to eliminate its rotational and angular dislocations. The fixation nails pre-arranged to the fracture line are driven into the head of the humerus to touch its internal cortical layer. The fixation nails projecting from the condyle are cut off leaving the 2-3-mm ends. The surgery is terminated by applying one suture on the skin in a place of insertion of the fixation nails and conducting antibacterial therapy for 4-5 days. The post-operative patient management involves an active workout of the humeral and elbow joints 2-3 days after post-traumatic pain syndrome relief with the exercises done 3-4 times a day until the operative upper extremity function is completely recovered.;EFFECT: by providing stable osteosynthesis and minimising soft tissue and periosteum injuries within the fractures, the method enables recovering the injured extremity function over a relatively short period of time and ensuring fracture consolidation as fast as possible.;4 cl, 1 dwg, 2 ex