RU2614099C1 - Method for neck of radius intramedullary osteosynthesis for children - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: two needles are passed: one through the styloid process of the distal radius, the other - through the distal radius over the ulna notch to the proximal fragment of the neck of radius. The needles are introduced into the proximal fragment without entering the joint cavity. The needles are bent and cut in the distal section. The limb is fixed by a plaster cast.

EFFECT: method allows to reduce trauma and increase the stability of fixation, prevent elbow joint contracture.

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Description

The invention relates to medicine, in particular to traumatology and orthopedics, and can be used in the treatment of patients with fractures of the radial neck in children.

A known method of surgical treatment of fractures of the neck of the radial bone [1], which is carried out as follows. Under general anesthesia, through the distal metaphysis of the radius, not reaching the growth zone of 3-4 mm, an intramedullary needle is inserted with a sharp curved end to the line of fracture of the neck of the radius. The curved sharp end of the spoke fixes the displaced head of the radius. The needle behind the “tail” end is rotated 180 degrees, which sets the radial head along an arcuate trajectory, leaves it under the skin, and imposes a posterior gypsum splint. The patient is discharged on the third day. Plaster is removed after a week and a half, the needle is removed after a month under local anesthesia. The disadvantage of this method is the technical complexity of introducing a curved spoke into the medullary canal, there is a high possibility of displacement of a fragment of the proximal radius in the medullary canal, due to the rotation of the knitting needle. It is also difficult to remove the spoke, since it has a curved end, which undoubtedly causes trauma to the bone marrow canal.

As a prototype, we took transarticular osteosynthesis with a spoke of the radial head [2]. The prototype method is as follows. After manual reduction of the radial head, osteosynthesis of a fragment of a straight needle is carried out through the condyle of the humerus, the cavity of the elbow joint, the head and neck of the radius in the position of flexion and supination of the forearm.

The disadvantages of the prototype method are as follows:

1. Blocking with the knee of the elbow joint causes this joint an additional lasting injury both during the operation and during the period of fixation of the fragment;

2. Prolonged fixation of the joint with a spoke for the period of fracture fusion promotes persistent contracture in the elbow joint;

3. High probability of damage to the metal due to the "fatigue" of the metal as a result of micromotion in the elbow joint;

4. This type of osteosynthesis does not provide sufficient stability, because rotational movements of the radial head along the axis of the spoke are preserved.

These shortcomings delay the duration of treatment and complete rehabilitation for an indefinite period.

The invention consists in a combination of essential features sufficient to achieve the desired technical result, which consists in the possibility of technically affordable, non-traumatic, stable osteosynthesis of the proximal radius of the bone in children, which provides prevention of contracture of the elbow joint.

The essence of the method of intramedullary osteosynthesis of the neck of the radial bone in children includes manual reposition, passing the spokes through the distal radius of the radius, under the control of an electronic optical transducer. Two spokes are carried: one through the styloid process of the distal radius, the other through the distal radius of the radius above the incision of the ulna to the proximal fragment of the neck of the radius. Spokes are inserted into the proximal fragment. Without going into the joint cavity, in the distal part, the needles are bent and bite, the limb is fixed with a plaster cast.

Holding two knitting needles: one through the styloid process of the distal radius, the other through the distal radius of the radius above the incision of the ulna, allows you to fix the fragments in the correct position.

Bringing the spokes to the proximal fragment of the radial neck and introducing them into the proximal fragment without leaving the joint cavity ensures stable fixation without trauma to the cartilage of the joint, which is the prevention of arthrosis.

The bending and biting of the spokes in the distal section is performed for the convenience of caring for the area of exit of the spokes and for the possibility of minimally invasive removal.

Fixation with a plaster cast is performed to ensure limb immobility.

The method is illustrated in the drawing, which shows a diagram of the osteosynthesis of the radial neck with two knitting needles: insert the spokes into the proximal fragment without leaving the joint cavity: one through the styloid process of the distal radius, the other through the distal radius of the radius above the incision of the ulna to the proximal fragment of the neck of the radius

The method is as follows. Under general anesthesia under aseptic conditions, a closed reposition of the proximal fragment of the radial neck is performed. Two spokes are carried: one through the styloid process of the distal radius, the other through the distal radius, above the incision of the ulna to the proximal fragment of the neck of the radius. Spokes are inserted into the proximal fragment. Without going into the joint cavity, in the distal part, the needles are bent and bite, the limb is fixed with a plaster cast.

Information sources

1. RF patent No. 2342092, A61B 17/56, BI No. 36, 2008

2. Burmakova G.M., Voronovich I.R., Goncharenko I.V. and other Traumatology and orthopedics. - M.: Medicine, 1997.588 s.

Claims (1)

A method of surgical treatment of the radial neck, including manual reposition, holding the knitting needle through the distal radius of the radial bone under the control of an electronic optical transducer, characterized in that two spokes are carried out: one through the styloid process of the distal radius, and the other through the distal radius of the radius above the notch the ulna to the proximal fragment of the neck of the radius, the needles are inserted into the proximal fragment without leaving the joint cavity, in the distal part of the spoke they are bent and bite, limb l fixed with a plaster cast.

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