RU2373916C2 - Method for treating forearm injuries - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology. Transosseous elements are inserted into bone fragments and thereafter fixed in an external fixation apparatus. They are inserted through acupuncture points of large intestine meridian (GI) and thin intestine meridian (IG). If forearm bones are injuries within upper one-third, the transosseous elements are inserted from radial bone through acupuncture points GI 9 (Shanglian) and from elbow bone - through IG 7 (Zhizheng). If bones are injuries within mid-third of forearm, the transosseous elements are inserted through acupuncture points GI 6 (Pianli) and from elbow bone through IG 6 (Yanglao). If bones are injuries within lower one-third of forearm, the transosseous elements are inserted from radial bone through acupuncture points GI 7 (Wenlju), from elbow bone through IG 6 (Yanglao).

EFFECT: method prevents complications in internal organs and inflammatory processes in soft tissues in insertion area of the transosseous elements, vegetotrophic impairements, and reduces time of treatment due to osteogenesis stimulation.

4 ex, 1 tbl, 29 dwg

Description

The present invention relates to medicine, namely to traumatology and acupuncture, and can be used to treat diaphyseal fractures of both forearm bones, as well as isolated injuries of the diaphysis of the ulnar and radial bones.

A known method of treating diaphyseal fractures of the forearm bones, the essence of which is that the base support of the external fixation apparatus in the form of a ring is applied to the distal fragments of both bones. Then, on the proximal fragments of both bones of the forearm, a cantilever spoke is carried out, which is fixed in the spokes of the external support of the apparatus, made in the form of a ring. Proximal and distal to the fracture site, two intermediate external supports of the apparatus are installed in the form of rings, to which distal and proximal fragments of both bones are fixed using cantilevered transosseous elements and transsegmental spokes, each fragment being separate. For separate control of the distal fragments of the radius and ulna, the spokes through them are carried out separately, each of the bone fragments being fixed to the main and additional supports of the Ilizarov apparatus so that these fragments can be manipulated in isolation. In the proximal and distal base supports, transsegmental transosseous elements held through both bones are fixed [1].

Closest to the proposed is a method of treating injuries of the forearm bones by introducing transosseous elements in those locations where the displacement of soft tissues is the smallest with all possible movements in adjacent joints and specific positions for the introduction of transosseous elements are determined. This takes into account the location of the neurovascular formations in the limb segment, acupuncture points and meridians. On the upper limbs are the meridians of energy movement:

- lungs (P) - YIN-meridian with a centrifugal direction;

- colon (GI) - Ya-meridian with a centripetal direction;

- triple heater (TR) - YAN-meridian with centripetal direction;

- small intestine (IG) - YAN-meridian with a centripetal direction;

- heart (C) - YIN-meridian with a centrifugal direction;

- pericardium (MS) - YIN-meridian with a centrifugal direction.

On the formed “functional” sections of the forearm bones, the optimal positions for the introduction of transosseous elements are indicated. On the forearm, 8 levels are determined relative to the ulna with the middle position of the forearm between supination and pronation. The authors of the known technology noted that when determining the “optimal” positions, the projections of BAP and meridians were not taken into account, since information on the value of the passage of transosseous elements through reflexogenic zones is ambiguous [2].

However, the known methods of treating fractures of the forearm bones have significant disadvantages, namely:

- possible complications resulting from damage by transosseous elements of the main neurovascular formations and their unconscious passage through bioenergy zones;

- unconscious damage and prolonged irritation of the reflex (acupuncture) skin areas with knitting needles during transosseous osteosynthesis leads to pathological reactions from the operated extremity: pain, soft tissue inflammation in the area of the needles passing through acupuncture zones, vegetotrophic disorders, dermatoses. The possibility of occurrence, due to the same cause, of an acute disease or exacerbation of the chronic process is not excluded [5, 6, 7]. With an adverse effect of transosseous elements on BAT or meridians in the groups of the examined, it was possible to expect the occurrence of acute or exacerbation of chronic diseases of the respiratory tract (P meridian), cardiovascular system (P, C, TR meridians).

Based on the analysis of known technologies for treating fractures of the forearm bones, as well as eliminating the disadvantages of known technologies, the task was to prevent inflammatory processes in the soft tissues in the area of transosseous elements, vegetotrophic disorders and possible complications from the internal organs, as well as reduce treatment time due to stimulation of osteogenesis.

The problem is solved as follows.

The treatment of injuries of the bones of the forearm is carried out by introducing transosseous elements into bone fragments, taking into account the location of the neurovascular bundles, acupuncture meridians and biologically active points, followed by their fastening in the external fixation apparatus. New in solving this problem is that transosseous elements are introduced through the acupuncture points of the meridian of the colon GI and the meridian of the small intestine IG. If the forearm bones are damaged in the middle third, transosseous elements are introduced from the radius through the acupuncture points GI 6 Pian-li and from the ulnar bone through IG 6 Yang Liao. When bones are damaged in the region of the upper third of the forearm, transosseous elements are passed from the radius through the acupuncture points GI 9 Shan-liang and from the ulnar bone through IG 7 Zhi-zheng. When bones are damaged in the region of the lower third of the forearm, transosseous elements are carried out from the radius through the acupuncture points GI 7 Wen-lu, from the ulnar bone through IG 6 Yang-liao.

We provide an explanation of the essential distinguishing features of the proposed "Method for the treatment of injuries of the bones of the forearm."

The introduction of transosseous elements into the distal and proximal fragments of the forearm bones through the acupuncture points of the large intestine meridian GI and small intestine meridian IG accelerates reparative osteogenesis and restores the normal anatomical and histological structure of the forearm bones in a shorter time, and also prevents inflammatory and trophic disorders in the zone fracture.

The choice of acupuncture points of the meridians of the colon (GI) and small intestine (IG) located on the forearm is determined by several points:

1. The intestine (in traditional Chinese medicine, the canals of the colon and small intestine) takes part in the general metabolism in the body. The most important functions of all sections of the intestine (GI and IG) are secretory, motor, excretory and absorption function.

2. For diseases of the musculoskeletal system, including damage to the bones of the forearm, according to the rules of acupuncture treatment, local points act on the acupuncture points around the lesion site.

3. On the distal sections of the arms and legs are located points of general or general strengthening action.

4. The selected acupuncture points are located on the dorsal-ulnar and dorso-ray lines of the forearm, which are convenient for transosseous elements through them. Selected acupuncture points of the large intestine meridian - GI 6 Pian-li, GI 7 Wen-liu, GI 9 Shang-lian and small intestine meridian - IG 6 Yang-liao, IG 7 Zhi-zheng are optimal for transosseous elements through them in case of damage bones of the forearm in the upper, middle, lower third and are necessary for:

- stimulating effect on the general metabolism in the body;

- normalization of metabolic and pathological processes at the site of damage;

- providing a general strengthening effect on the body.

To substantiate the selected biologically active points with the introduction of transosseous elements in the area of damage to the bones of the forearm (in isolation of the ulnar, radial, or both bones), experimental studies were conducted on rabbits. Two groups of animals were distinguished:

- the first group of animals - transosseous elements held through the acupuncture points of the meridians of the colon (GI) and small intestine (IG).

- the second group of animals - control - transosseous elements held outside acupuncture points and meridians.

Two acupuncture points were chosen on the rabbit’s forearm: colon canal — GI 6 Pian-li and small intestinal canal — IG 6 Yang-liao. The localization of acupuncture points was determined by the topographic-anatomical method, taking into account the proportional tsunami. GI 6 Pyan-li (Lo-point) is located on the front surface of the rabbit’s forearm (on the back-ray line along Zhu Lian) between the extensor tendons of 2-3 fingers 3 cuns proximal to the fold of the wrist joint (corresponds to position 2 at level VII). IG 6 Yang-Liao (analgesic) is located one cuns proximal to the wrist fold on the posterior-outer surface of the rabbit's forearm (on the dorsal-ulnar line along Zhu Lian) and corresponds to position 8 at level VII of the ulna.

In the first and second (control) groups of animals (rabbits), studies were carried out in the following terms:

- 5th day of the distraction period (10 days of the experiment);

- 10th day of the distraction period (15 days of the experiment);

- 10th day of the fixation period (25 days of the experiment);

- 20th day of the fixation period (35 days of the experiment).

As a result of an experimental study on the 35th day of the experiment it was found:

The control second group of animals (rabbits). Transosseous elements held outside acupuncture points.

By 10 days of the distraction period, a number of animals showed inflammation, hyperemia, and soft tissue edema in the area of transosseous elements, which was stopped by antibacterial therapy. The appetite and activity of the animals were reduced.

On the 20th day of the fixation period on radiographs, the diastasis between the fragments is filled with bone tissue of uniform density. In the middle of the diastasis, an enlightenment band with fuzzy contours and various optical densities is preserved. A bone marrow canal and a cortical layer are formed (see the appendix to the description, Fig. 1).

Morphologically, in the distraction site, active proliferation of osteocytes and fibroblasts is observed, mainly due to the endostomy. The peripheral bone plate of compact bone is not expressed and does not connect the ends of the damaged bone. The medullary canal is not formed. Diastasis is filled with bone beams oriented both in the longitudinal and transverse directions. Loose beams are located, but there are also dense areas. In the middle, a loose area consisting of fibroblasts is noted. When stained according to Van Gieson, friable areas are represented by thin connective tissue fibers that have a delicate pink color. Bone beams and dense bone tissue have a pronounced red color. The bone marrow is empty. The vascular channels are well defined and are filled with the formed elements of the blood. Chondrocytes do not occur. Membrane structures and single cells are detected (see the appendix to the description, figure 2).

The first group of animals (rabbits) - transosseous elements held through biologically active points.

During the entire period of the experiment, no inflammatory and trophic disorders were detected in the area of application of the external fixation apparatus. Animals were active, appetite normal.

X-ray on the 35th day of the experiment — distraction regenerate — 10 mm; a cortical layer and a medullary canal were formed. A massive periosteal reaction was noted (see the appendix to the description, Fig. 3).

On histograms (see the appendix to the description, figure 4) at the site of the distillation regenerate the active reaction of osteogenesis is microscopically well defined due to the formation of bone trabeculae from the endosteum. The newly formed bone trabeculae form plexuses between which the vessels are visible, which resembles the structure of the cancellous bone. There are sites with proliferation of fibroblasts. There are no foci of chondrocytes. The bone marrow is empty.

130 patients with injuries of the forearm bones were treated at the Clinic of the State Institution of Scientific Center for Internal Medicine of the All-Russian Medical Center of the SB RAMS: diaphyseal fractures of both bones of the forearm (40), radius (23), ulna (13), defect diastasis of the radius (5) and ulna ), defect-pseudoarthrosis of the diaphysis of the ulna (5) and both bones (11), damage to Montegya (13), Galleatsi (14).

All patients with injuries of the forearm bones underwent transosseous osteosynthesis. Patients were divided into three groups. The first group included 33 people who, during the operation, transosseous elements were performed outside the BAP and outside the meridian lines (LM); in the second group - 56 patients with the intersection of LM, and the third group consisted of 41 patients with holding spokes and / or rods through the proposed BAP.

To identify vegetotrophic disorders in the injured limb before surgical treatment and in the early postoperative period, a study was made of the functional state of the neuromuscular apparatus by stimulation electroneuromyography [8] using the NMA 4-01 Neuroman analyzer. The thresholds of excitability (PV) were determined during stimulation of the peripheral nerves of the upper extremities: n. radialis, n. medianus, n. ulnaris in three groups examined before surgical treatment and in the early postoperative period.

In the study of the functional state of the neuromuscular apparatus, it was found that in all groups of patients there was an initial asymmetry of excitability parameters from 9-12% to 26% relative to the values of the intact limb. It should be noted that in the group where transosseous elements passed outside the BAP and meridians and in the group with "random" transosseous fixation through the BAP, the excitability of peripheral nerves was reduced. In the group where transosseous elements passed through the proposed BAP, the excitability of the radial, median, and ulnar nerves was increased (by 12%) (see table). The indicators on a healthy intact limb were taken as the norm.

Table Excitability threshold indices in the examined groups Test nerves The threshold of excitability (Mk. In D) in the groups examined one 2 3 n radialis Before surgery 22 26 20.8 After operation 22 23.7 20,4 Norm 17.7 23.8 23.5 n medianus Before surgery 16.9 17.1 15.6 After operation 16.5 18.8 15.7 Norm 13.9 14.2 15.3 n ulnaris Before surgery 14.5 12 9.1 After operation 10.6 12 10.3 Norm 10.3 10 11.3

The study of the excitability parameters in the early postoperative period showed a slight change in the excitability threshold of the radial and ulnar nerves, for the median nerve in the first and second groups there was an increase in excitability thresholds by 16 and 50%, respectively.

In the third group in the postoperative period, the threshold of excitability of the radial nerve remained at the level of the initial state, the threshold of excitability of the ulnar nerve was approaching normal values, and the function of the median nerve corresponded to the norm both before and after the operation.

Thus, the actual absence of dynamics of the threshold indicators of excitability in the group with the passage of transosseous elements through the proposed BAT (meridian of the large intestine - GI 6 Pian-li, GI 7 Wen-lu, GI 9 Shang-lian and small meridian - IG 6 Yang-liao , IG 7 Zhi-zheng) confirms the absence of pathological reactions in the limb.

1. In the group of patients in whom transosseous elements were drawn through biologically active points or crossed the lines of classical meridians, neither complications from the internal organs nor inflammatory processes of soft tissues around transosseous elements were noted.

2. Indices of stimulatory electromyography in the group of patients in whom transosseous elements are drawn through biologically active points indicate less pronounced vegetotrophic disorders than in other groups.

3. There was a decrease in the fixation time in AVF in patients who received transosseous elements through biologically active points (by 2-2.5 weeks), ie the introduction of transosseous elements through BAP during transosseous osteosynthesis is advisable to stimulate osteogenesis.

The essence of the proposed "Method for the treatment of injuries of the bones of the forearm" is as follows.

In accordance with the practice of acupuncture, the forearm is divided into 12 proportional tsunami. Given the topographic and anatomical layout of the muscles, ligaments relative to the bone structures, taking into account the data of Rg-graphs, determine the location of the fracture. Then, the passage of the large intestine meridian (GI) and small intestine (IG), on which the location of the acupuncture points of the large intestine meridian — GI 6 Pian-li, GI 7 Wen-li, GI 9 Shan-liang - is determined on a healthy intact upper limb of the patient. small intestine meridian - IG 6 Yang-Liao, IG 7 Zhi-zheng. Then, in accordance with the unified designation of transosseous osteosynthesis [3, 4], the forearm is schematically divided into eight equidistant levels (I-VIII). Level I is indicated in the projection of the neck of the radius, retreating 1.5-5 cm distal from the top of the ulnar process. Level VIII, retreating proximal 2 cm from the apex of the styloid process. Each of the eight conventional slices of the forearm made in the transverse plane is divided into twelve equal-sized sectors (by analogy with the watch dial), indicated by positions 1-12. The condition is accepted that position 3 is always located on the inner surface of a limb segment. At the same time, the angle of transosseous elements must be indicated with respect to the axis of the segment. Symbols from an intact limb are transferred to a damaged limb. Transosseous elements are carried out in the middle position of the forearm, taking into account sections of levels I-YIII with the positions from 1-12, the meridians and acupuncture points (see the appendix to the description, figure 5). Four fragments of the screw and the ulnar bone are consecutively carried by four screw rods (two to the proximal fragment and two to the distal fragment) at an angle of 90 ° to the longitudinal axis of the bone in the sagittal plane, given the location of the acupuncture points, the large intestine meridian - GI 6 Pyan-li , GI 7 Wen-Liu, GI 9 Shan-Liang and the small intestine meridian - IG 6 Yang-Liao, IG 7 Zhi-zheng. Depending on the fracture level, mandatory acupuncture points for transosseous elements are determined to stimulate reflex zones.

So, in case of fracture of the forearm bones in the upper third, transosseous elements in the fragments of the radius are performed at level III of the unified technology: position 2 through the acupuncture point GI 9 Shan-liang and from the ulnar bone at level V, position 6, through the acupuncture point IG 7 Zhi chen.

In case of fracture of the forearm bones in the middle third, transosseous elements from the radius are performed at the VII level of the unified technology of transosseous osteosynthesis, position 2 through the acupuncture point GI 6 Pyan-li and transosseous elements are introduced into the fragments of the ulna at the VIII level, position 8 through the acupuncture point IG 6 Yang Liao.

In case of fracture of the forearm bones in the lower third, transosseous elements are carried out from the radius at the V level, position 12 through the acupuncture point GI 7 Wen-lu. From the side of the ulna, transosseous elements are introduced at the VIII level, position 8 through the acupuncture point IG 6 Yang-Liao.

Then, each of the transosseous elements performed, for example, screw rods, is fixed with brackets and a reposition unit in the external supports of the external fixation apparatus. Distal and proximal bone fragments are fixed to external supports made in the form of a sector 1/4, and intermediate - to sectors 3/4 from the circumference of the ring of the Ilizarov apparatus. External supports are connected in series with threaded rods. The device is stabilized.

The essence of the proposed "Method for the treatment of injuries of the forearm" is illustrated by clinical examples.

Example 1. Patient L., 37 years old, medical history No. 58446, was admitted to the clinic GU SC RVH VSNTS SB RAMS with complaints of pain in the left forearm on the inability to fully use the left upper limb.

From the anamnesis of the disease: household trauma - falling onto an elongated left upper limb. Surgical treatment at the place of residence: intramedullary osteosynthesis and additional gypsum immobilization. The clinic was admitted 4 months after the injury with signs of the formation of a false joint.

Objectively: asymmetry of the forearms due to atrophy of soft tissues on the left throughout. Movements in adjacent joints are limited: in the elbow - 125/30/0, in the wrist - 30/0/30, rotation of the forearm - 30/0/0. On the radiograph of the left forearm at the level of the middle third of the diaphysis, there is a violation of the integrity of both bones. Metal construction (see the appendix to the description, Fig.6, c).

Diagnosis: a false joint in the middle third of the diaphysis of both bones of the left forearm, combined contracture of adjacent joints.

Operation performed: removal of intramedullary spokes from both bones of the left forearm. The second stage performed transosseous osteosynthesis according to a unified pattern of superposition of transosseous elements (spokes and rods) (see the appendix to the description, Fig.6, a):

Four screw rods (two into the proximal fragment and two into the distal fragment) were successively carried out into fragments of the radius bone at an angle of 90 ° to the longitudinal axis of the bone in the sagittal plane. Each screw rod with brackets and a reposition unit is fixed to external supports (distal and proximal to 1/4 sectors, intermediate to 1/4 sectors from the circumference of the Ilizarov apparatus ring). External supports are connected in series by threaded rods. Similarly, four rods-screws (two into the proximal fragment and two into the distal fragment) are sequentially drawn into fragments of the ulnar bone at an angle of 90 ° to the longitudinal axis of the bone in the sagittal plane. Each screw rod with brackets and a reposition unit is fixed to external supports (distal and proximal to 1/4 sectors, intermediate to 1/4 sectors from the circumference of the Ilizarov apparatus ring). External supports are connected in series by threaded rods. The device is stabilized. Two transosseous external fixation apparatuses are superimposed in isolation on each bone of the forearm with the ability to perform rotational movements (see the appendix to the description, Fig.6, c). All transosseous elements are held outside acupuncture points. In the postoperative period, angina attacks were observed (treatment by a therapist), soft tissue inflammation around the exit of transosseous elements (inflammation was stopped by a course of antibacterial therapy). The fixation period in the apparatus was 210 days (see the appendix to the description, Fig.6, d).

Example 2. Patient R., 29 years old, medical history No. 56228, was admitted to the clinic GU SC RVH VSSC SB RAMS with a diagnosis of pseudarthrosis of the middle third of the diaphysis of both bones of the left forearm, combined contracture of adjacent joints (see the appendix to the description, Fig.7 , at).

From the anamnesis of the disease: industrial injury: the left hand fell into a rotating mechanism. At the place of residence, transosseous osteosynthesis of the left forearm was performed. The fixation period was 131 days, then 30 days plaster immobilization. He went to the clinic 5.5 months after the injury with signs of the formation of a false joint of both bones.

The operation was performed in the clinic: transosseous osteosynthesis with the rod apparatuses of both bones of the left forearm.

We present a unified superimposition scheme of the external fixation apparatus (see the appendix to the description, Fig. 7, a).

In the fragments of the ulna, four screw rods (two into the proximal fragment and two into the distal fragment) were successively carried out at an angle of 90 ° to the longitudinal axis of the bone in the sagittal plane. Each screw rod with brackets and reposition unit is fixed to external supports (distal and intermediate screw rod on the distal fragment - to one 1/3 sector, on the proximal fragment, the proximal and intermediate rod - to one 1/3 sector from the circumference of the apparatus ring Ilizarova). External supports are connected in series by threaded rods. The device is stabilized.

Similarly, four rods-screws (two into the proximal fragment and two into the distal fragment) are sequentially drawn into fragments of the ulnar bone at an angle of 90 ° to the longitudinal axis of the bone in the sagittal plane. Each screw rod with brackets and a reposition unit is fixed to external supports (distal and intermediate screw rod on the distal fragment - to one 1/3 sector, on the proximal fragment - the proximal and intermediate rod - to one 1/3 sector from the ring circumference Ilizarov apparatus with a diameter of 130 mm). External supports are connected in series by threaded rods. The device is stabilized. Two transosseous external fixation apparatuses are superimposed in isolation on each bone of the forearm with the possibility of performing rotational movements (see the appendix to the description, Fig. 7, c).

The screw-rod is inserted into the ulnar bone at the VI level through the acupuncture point IG 6.

A screw shaft is inserted into the radius at level VII through GI 6.

The postoperative period without complications.

The fixation period was 134 days (see the appendix to the description, Fig.7, d).

Example 3. Patient B., 22 years old, was admitted to the Clinic of the State Institution SC SC RVH VSSC SB RAMS 3 days after the injury.

Diagnosis at admission: Montage fracture-dislocation (fracture of the proximal third of the ulna with displacement of fragments and dislocation of the radial head) to the left (see the appendix to the description, Fig. 8, c).

Surgical intervention performed: combined transosseous osteosynthesis of the left forearm according to the following scheme (see the appendix to the description, Fig. 8, a):

A needle was drawn through the ulna at the first level in the frontal plane (4-10); at level II, a rod was introduced in the plane (7.115 °). Both transosseous elements are fixed to the proximal base external support 3/4 of the ring, diameter 140 mm. A transosseous element is fixed to the same base - a rod inserted into the radius in the sagittal plane at level II at 11, 90 °.

The distal basic external support of the apparatus in the form of a sector 1/4 of the ring of the Ilizarov apparatus, diameter - 140 mm, is fixed to the rod inserted in the oblique-sagittal plane at level VI at 7.75 °.

Repositioned transosseous element - the rod was carried out at the V level at the position 6.90 ° of the middle third of the diaphysis of the ulna in the sagittal plane and fixed in the intermediate external support in the form of a sector 1/4 of the ring, diameter - 140 mm (see the appendix to the description, FIG. 8, c).

A core inserted into the ulna V6.90 ° passes through the acupuncture point IG 7.

A rod inserted into the radius II, 11.90 °, passes through the acupuncture point GI 9.

The postoperative period without complications. The fixation period was 137 days (see the appendix to the description, Fig. 8, d).

Example 4. Patient K., 42 years old, was admitted to the Clinic of the SC SC RVH VSNTS SB RAMS 3 weeks after the injury.

Diagnosis at admission: a closed fracture of the diaphysis of both bones of the left forearm in the distal third with a displacement of bone fragments (see the appendix to the description, Fig. 9, c).

Surgical intervention was performed in the clinic: combined transosseous osteosynthesis of the left forearm according to the following scheme (see the appendix to the description, Fig. 9, a):

The device is stabilized.

Through the ulnar bone at level I, a spoke was drawn in the frontal plane (4-10) and the rod at level II through both bones was 5.90 °. Both transosseous elements are fixed to the external support in the form of a 3/4 ring of the Ilizarov apparatus, diameter - 130 mm.

The distal base external support in the form of a ring with a diameter of 130 mm is fixed to the spoke held at the VIII level in the sagittal plane through both bones 6-12, the rod 6, 90 °, drawn through the ulnar bone at the VI level, and the rod 5.90 ° introduced into the radius at the VI level in the sagittal plane position 10, 90 °.

In the intermediate support (a ring with a diameter of 130 mm) at the V level of the middle third of the radius of the radial bone in the frontal plane, a 9-3 rod was inserted, a 6.90 ° rod was inserted into the ulnar bone.

The screw-rod is inserted into the ulnar bone at level VI at position 5, 90 ° through the acupuncture point IG 6.

A screw-rod is inserted into the radius at the VI level of position 10.90 ° through GI 7 (see the appendix to the description, Fig. 9, c).

The postoperative period without complications. The fixation period in the external fixation apparatus was 105 days (see the appendix to the description, Fig. 9, d).

Thus, the proposed “Method for the treatment of fractures of the forearm bones” in comparison with the known technologies prevents inflammatory processes in the soft tissues in the area of transosseous elements and vegetotrophic disorders, as well as the occurrence of complications from the internal organs, for example, such as angina attacks, disorders from gastrointestinal tract, and many others, can reduce treatment time by stimulating osteogenesis by an average of 2-3 weeks and accelerate social rehabilitation patients with injuries of the bones of the forearm.

Information sources

1. Solomin L.N. Fundamentals of transosseous osteosynthesis apparatus G.A. Ilizarov: Monograph. - SPb. LLC MORSAB AV, 2005. - C 200-202.

2. Barabash A.P., Solomin L.N. "Esperanto" of transosseous elements during osteosynthesis by Ilizarov apparatus. - Irkutsk, 1997 .-- S.24-26, 45.

3. Solomin L.N. et al. Method for the uniform designation of transosseous osteosynthesis // Methodical recommendations of the Ministry of Health of the Russian Federation No. 2002/134.

4. RF patent No. 2123307, MKI A61B 17/56. A method for treating damage to long bones and a device for its implementation. Bull. No. 35, 1998.

5. Barabash A.P., Verkhozina T.K., Glushchuk A.G. External fixation devices using Russian technology in combination with traditional Chinese medicine are the key to successful treatment of bone fractures // Mat. Int. conf. BEIHEI'97 in manual medicine and traditional therapy. - Beihai, Guangi, P.R. China, 1997. - P.87-89.

6. Verkhozina TK, Solomin LN, Shevchenko VV Analysis of the results of transosseous elements through biologically active points // The First International Pacific Congress on Traditional Medicine: abstracts. - Vladivostok: Voronezh State Medical University, 1998. - P.74-75.

7. Novikova E.B., Paltseva I.S., Oganesyan O.V. et al. A system for treating damage to bones and joints, taking into account the role of biologically active areas of the skin. - M .: BINOM. Laboratory of Knowledge, 2004. - 120 p.

8. Verkhozina TK, Puseva M.E., Ippolitova E.G. The effect of damage and prolonged irritation of acupuncture points by transosseous fixatives on reparative osteogenesis during diaphyseal injuries of the bones of the forearm. // Reflexotherapy. - 2006. - No. 4 (18). C 24-27.

Claims (1)

A method of treating injuries of the forearm bones, including the introduction of transosseous elements into bone fragments, given the location of the neurovascular bundles, acupuncture meridians and biologically active points, followed by their attachment to an external fixation device, characterized in that transosseous elements are introduced through the acupuncture points of the colon meridian GI and meridian of the small intestine IG, while in case of damage to the bones of the forearm in the upper third, transosseous elements are introduced from the side of the radius through acupuncture points GI 9 Shan- yang and from the side of the ulna through IG 7 Zhi-zheng, in case of damage to the bones in the middle third of the forearm, transosseous elements are carried out from the side of the radius through acupuncture points GI 6 Pyan-li and from the side of the ulna through IG 6 Yang-lao, in case of damage to bones in the region of the lower third of the forearm, transosseous elements are carried out from the radius through the acupuncture points GI 7 Wen-lu, from the ulnar bone through IG 6 Yang-lao.

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