Method for fixing bone fragments condyle shoulder in comminuted fractures and device for its implementation

 

(57) Abstract:

Usage: in medicine, namely to traumatology. Use the device that contains the legs, metal body with plastic head. In the legs and head are made of two parallel through holes passing in the frontal plane. In the lateral parts of the condyle fragment together with attached to them ligaments and muscles form two channel coinciding with the holes in the body of the endoprosthesis, and fix the fragments to him by metal constructions. The technical result is to increase the fixation strength of muscles and ligaments to the endoprosthesis. 2 C. p. F.-ly,3 ill.

The invention relates to medicine, namely to traumatology and orthopedics, and is intended for operative treatment of comminuted fractures of the condyle of the shoulder and their consequences.

There is a method of fixation of the muscles to the implant. C. N 1066562 from 04.08.81), which is to install the endoprosthesis and applied to the shoulder part of his ceramics with biological glue and fixing muscle to these surfaces. The disadvantage of this method is the unreliability of such fastening living tissue to the implant.

Closest to the claimed is ustroystvo. C. N 1600757, class A 61 F 2/38, 1990). The disadvantage of this device is that it is not possible fixing of bone fragments condyle with attached muscles. Thus the fixation of the muscle is maintained by scar tissue and may not be reliable.

Our proposed device differs from the above analogs, because in the casing 1 and the head 2 of the prosthesis is performed through hole 3 passing in the frontal plane (Fig. 1 and 2). In the lateral parts of fragments condyle shoulder together with attached to them by the muscles and ligaments form a two channel 3, which coincide with the holes in the housing 1 of the prosthesis (Fig. 3) and fix the fragments to it metal structures (for example the 4 screws or bolts). This improves the stability of the joint, which is the prevention of subluxation, and to preserve the anatomical region natural fasteners muscles flexors and extensors of the hand and fingers, which is beneficial to their function.

The proposed method is as follows. The rear longitudinal incision at the elbow joint length of 15 cm allocated to the tendon of the triceps muscle, which together with the lower third of the muscle and the periosteum in Li nerve. Remove loose fragments of the Central part of the condyle shoulder, keeping his lateral together with the attached ligaments and muscles. Installed implant and forming drill two valves in the lateral parts of the condyle, which coincides with the direction of the holes in the body of the endoprosthesis. Fix fragments with screws or bolts to the prosthesis so that the wound surface of the diaphysis and fragments condyle contact (in the presence of false joint fragments refresh). The wound in layers sew.

Clinical example. Patient D., aged 57. I. B. N 384/94, was admitted to the Department of the Institute with a diagnosis of closed comminuted fracture of the right condyle of the humerus with displacement of fragments. 24.01.94 was performed according to the described method. Within 3 weeks of immobilization was carried out joint plaster splint. 9 months after surgery of motion in the joint in sufficient volume (amplitude 100oand the joint is stable. On radiographs is determined by the fracture fragments condyle with the Central tomcom and excessive ossification on the lateral surfaces of the condyles.

A similar operation is performed for another two patients. Long-term results are good.

1. Method for fixing bone fragments condyle is muscle characterized in that the use of prosthesis, consisting of legs, head and body, having two parallel through holes in the lateral parts of the condyle fragment together with attached to them ligaments and muscles form two channel coinciding with the holes in the body of the endoprosthesis, and fix the fragments to it metal.

2. A device for fixation of bone fragments condyle shoulder in comminuted fractures containing legs, the metal body of the endoprosthesis with a plastic head, characterized in that the legs and head are made of two parallel through holes passing in the frontal plane.

 

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EFFECT: higher efficiency of therapy.

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EFFECT: higher efficiency of therapy.

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FIELD: medicine, traumatology, orthopedics.

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EFFECT: increased accuracy of reposition, improved conditions for fusion.

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EFFECT: complete repair of mobility in articulation.

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FIELD: medicine.

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