RU2392895C1 - Surgery technique for shoulder-slip - Google Patents

Abstract

FIELD: medicine. ^ SUBSTANCE: invention concerns medicine, namely orthopaedics. A tendon of the long muscle of biceps muscle of arm is separated and held. The tendon is cleaned from peritendineum. The intertubercular transverse is deepened with removing periosteum and a bone surface. The tendon is restored in the intertubercular transverse. It is followed with osteotomy of radial bone at a distance from the external and internal edges of the transverse. The created flaps of bone are fractured to cover the tendon. The flaps are strengthened with three bone sutures. ^ EFFECT: when using the technique, the tendon is enabled to grow together with the humeral bone and to change to a ligament that prevents dislocation of the humeral bone. ^ 1 ex, 4 dwg

Description

The invention relates to medicine and relates to methods for surgical treatment of diseases of the musculoskeletal system, in particular patients with a habitual dislocation of the shoulder.

Known methods for surgical treatment of habitual dislocation of the shoulder.

1. Method A.F. Krasnova [1].

The essence of the method: moving the tendon of the long head of the biceps of the shoulder to the gutter, formed at the base of the large tubercle of the humerus, followed by covering the gutter with a bone leaf.

The disadvantages of the method: trauma, the movement of the tendon leads to stretching of the tendon fibers, the development of a degenerative process, the weakening of mechanical strength.

2. The method of G.P. Kotelnikova et al. [2].

The essence of the method: placing the scarified tendon of the long head of the biceps of the shoulder in a deep inter-tubercle groove with lining of the tendon with pieces of canned bone.

The disadvantages of the method: the use of allogeneic material as a graft, the possibility of developing a reaction of the body to the graft.

Method G.P. Kotelnikova et al. Taken as a prototype.

The purpose of the invention is to increase the effectiveness of treatment of patients with habitual dislocation of the shoulder, reducing the number of complications and relapses. This goal is achieved by the fact that the tendon of the long head of the biceps of the shoulder is covered with bone cusps formed by osteotomy of the humerus along the edges of the inter-tubercle groove, which are fastened with three bone sutures.

Comparison of the proposed method with others known in the field of medicine, showed its compliance with the criteria of the invention.

The invention is illustrated by graphic material. Figure 1-4 presents the stages of the operation of the proposed method.

The method is as follows: the tendon of the long head of the biceps muscle of the shoulder 2 is isolated and taken on the holder 1, on the humerus 3 the inter-tubercle groove 4 is deepened with a grooved chisel 5, removing the periosteum and the surface layer of the bone (Fig. 1). Tendon 2 is freed from adhesions, peritononia is removed and placed in the inter-tubercle groove 4 in its original place (figure 2). Osteotome 6 produce an osteotomy of the humerus 3, departing from the outer and inner edges of the furrow at a distance of 1 cm, a depth of 0.8 cm (figure 3). The resulting bone sash 7 break at the base and cover them with a tendon 2. Sash 7 strengthen three bone sutures 8 (Fig.4). The tendon fuses with the humerus and turns into a ligament that prevents the dislocation of the humerus.

The fundamental difference between the proposed method and the method of A.F. Krasnov is the minimally invasive technique that avoids stretching the fibers of the displaced tendon, and the subsequent development of a degenerative process.

The advantage of the proposed method over the prototype (the method of G.P. Kotelnikov et al) is to use the fixation of the tendon with its own tissues - formed by bone leaflets, which excludes the reaction of the body to foreign transplants. The tendon fuses with the bone, forming a ligament of the shoulder, which prevents the displacement of the head of the shoulder.

The proposed method with a positive effect is performed in one patient with the usual dislocation of the shoulder.

Clinical example

Patient M, 23 years old, was admitted to the clinic of traumatology and orthopedics on October 5, 2007 with a diagnosis of habitual dislocation of the right shoulder. October 7 was operated on by the proposed method. The shoulder joint is immobilized with a Deso bandage reinforced with plaster bandages. The dressing was removed after 6 weeks. Postoperative rehabilitation was carried out. Viewed on December 21. The result is positive.

The method is advisable to use in trauma and orthopedic departments of medical institutions.

USED BOOKS

1. G.P. Kotelnikov, A.F. Krasnov, V.F. Miroshnichenko. Traumatology. M.: 2001, p. 143.

2. RF patent No. 2223058 "Method for the surgical treatment of habitual dislocation of the shoulder", 2004.

Claims (1)

A method of surgical treatment of a habitual dislocation of the shoulder by placing the scarified tendon of the long head of the biceps of the shoulder muscle in the deep intercuspal groove, characterized in that the tendon of the long head of the biceps of the shoulder is covered with bone cusps formed by osteotomy of the humerus along the edges of the intercuspal grooves that hold together.

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