RU2231319C2 - Method for treating sternal fractures - Google Patents

Abstract

FIELD: medicine, surgery.

SUBSTANCE: one should apply an allotransplant of "Alloplant" type between sternal fragments, medicinal glue named "Sulfacrylate" should be preapplied onto the site where allotransplant touches osseous edges, moreover, transplant's thickness corresponds to 5-10 mm along the whole contact line, and its size should exceed that of diastasis of osseous fragments for 1 cm that provides reliability of biological fixation of sternal fragments.

EFFECT: higher efficiency of therapy.

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Description

The invention relates to medicine, namely to surgery, and can be used to treat sternal fractures.

A known method of external traction fixation and skeletal traction for the sternum during its fractures, adopted as an analogue [1]. The method consists in the fact that skeletal traction is carried out and fragments are fixed using a temporary mechanical clamp in the form of a clamping clamp.

The disadvantage is that with this method, sternal osteomyelitis can develop and the patient is in a forced position for a long time.

There is also a method of fixing fragments of the sternum by stitching them with the device SGR-20 using tantalum staples, adopted as a prototype [2].

However, due to respiratory movements of the chest, the staples often open and bone fragments diverge, which causes complications and an increase in the duration of treatment.

EFFECT: improved quality and reduced treatment time by providing reliable biological fixation of fragments of sternum.

The technical result is achieved by the fact that in the method of treating sternal fractures by fixing and reposition of bone fragments relative to each other, fixation is performed by placing an allograft between bone fragments, medical glue is preliminarily applied to the junction of the allograft with the edges of the bones, and the thickness of the allograft is 5 ... 10 mm over the entire thickness of the contact, and the allograft plays the role of a spacer fixing bone fragments; as an allograft use the preparation of the Alloplant series; as the glue connecting the allograft with the edges of the bone fragments, the sulfacrylate medical glue is used.

The method is as follows. Under local or general anesthesia, the ends of the sternum fragments are isolated. The edges of the latter are treated with 96% alcohol solution and “Sulfacrylate” medical adhesives are applied [3]. An allograft [4] is placed between the sternum fragments and fragments are repositioned. The size of the allograft should exceed the size of the diastasis of bone fragments by 1 cm, which allows it to be tightly fixed. This creates immobility of bone fragments in relation to each other. This prevents the displacement of fragments and quickly relieves pain. An allograft is characterized by high strength and ductility, has structural adjustment during transplantation. The use of this method does not require additional fixation of the sternum and the forced position of the patient.

Example 1. Patient M., 24 years old. Diagnosis: Dull chest injury. Closed sternal fracture. Under general anesthesia, the ends of the fragments of the sternum were selected, their processing with bone nippers. An allograft was prepared in size, exceeding the diastasis between bone fragments by 1 cm. The bone hooks had their ends raised, while the diastasis between the fragments was 0.8 cm. The ends of the bone fragments were treated with 96% alcohol solution and “Sulfacrylate” medical glue was applied to them. Allotranspalontate was inserted into the lumen between the fragments with 2 cm ramers in the form of a “spacer” over the entire width of the sternum. Reposition of fragments of the sternum. The postoperative period was uneventful. Healing of skin wounds by primary intention. Discharged on the 10th day. Control after 2.4 months. No pathological changes were detected.

Example 2. Patient C., 18 years old. Diagnosis: stab wound to the chest with the intersection of the sternum. Heart wound. Made suturing wounds of the heart. Fragments of the sternum are fixed to each other by an insert — a “spacer” with an allograft on the sulfacrylate medical glue according to the procedure described in Example 1. Secondary healing. Discharged on the 16th day. Control examination after 3 months. An X-ray examination reveals restoration of the bone structure.

In total, 18 patients were operated on using the described technique. Compared with the known methods of treating sternal fractures, the proposed method has the following advantages:

- halved treatment time;

- the pain syndrome is quickly stopped;

- reliable prevention of the development of sternal osteomyelitis is created;

- the frequency of purulent-inflammatory complications decreases.

Sources used

1. Kosarev V.P. Terminal block for external traction fixation in case of terminal rib fractures. // Bulletin of Surgery. Grekov. 1980.V. 124. No. 4. P. 104-105.

2. Wagner EA Breast Damage Surgery. - M.: Medicine. 1981.p. 128-136.

3. Plechev VV, Leplyanin GV, Kornilayev P.G. Sulfacrylate. Ministry of Health of the Russian Federation, RAS, UO Institute of Organ. chemistry. 1992. Ufa.

4. Avzaletdinov AM, Sibagatullin NG, Ismagilov F.Sh .. Treatment of bronchial fistulas with the use of an alloplant / Materials of the XVII Conference of Surgeons of the Republic of Bashkortostan. - Ufa. 1992. - S. 78-79.

Claims (1)

A method for treating sternal fractures by fixing and reposition of bone fragments relative to each other, characterized in that the Alloplant series allograft is placed between the bone fragments, fixed with Sulfacrylate medical glue, while the allograft thickness is 5-10 mm over the entire contact length, and its size should exceed the size of the diastasis of bone fragments by 1 cm.