METHOD OF OSTEOSYNTHESIS IN FRACTURES OF PROXIMAL HUMERUS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to traumatology, and can be used for reposition of fragments in fractures of proximal humerus. Deltopectoral approach to shoulder joint is performed with incision of skin and subcutaneous fat between deltoid and large pectoral muscles. Implant is a plate with blocking holes for osteosynthesis of fractures of the proximal humerus. Tendons are sutured – at first, subscapular muscle, then supraspinatus and infraspinous with separate threads. After the tendons are sutured, the ends of the threads are passed through the holes located along the front, upper and posterior edges of the plate, oriented to the stroke of the stitched muscles. Then, under the electron-optical converter, the plate is centered relative to the articular surface of the head of the humerus so that the angle between the plane of the articular surface and the longitudinal axis of the plate corresponds to the cervical-diaphyseal angle of the humerus, for which a central pin is inserted into the central hole in the plate, followed by reposition of the fragments by traction beyond the ends of the threads by pulling all 3 threads together, pressing the plate with the finger to the reimbursed fragments of the humerus. Plate is fixed to the proximal humerus with interlocking screws. Filaments ends fixing to holes in plate.;EFFECT: invention provides more reliable fixation of fragments both in simple 2-fragmentary and severe 3-4-fragment fractures of the proximal humerus, on any post-traumatic fractures, while minimizing the risk of postoperative complications.;8 cl, 6 dwg, 1 tbl, 1 ex