METHOD OF SURGICAL TREATMENT OF MASSIVE NON-RECOVERABLE RUPTURES OF A ROTATOR CUFF OF A SHOULDER JOINT USING ARTHROSCOPICALLY ASSISTED TECHNIQUES OF TRANSPOSITION OF THE LATISSIMUS DORSI

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to traumatology and orthopedics, and can be used for treating patients with massive non-recoverable rupture of rotator cuff. An additional supra-pectoral arthroscopic port is used to dissect the tendon of latissimus dorsi at the point of attachment on the crest of a small tubercle of the humerus with the use of a hydropreparation. It is followed by augmentation of the tendon of the latissimus dorsi with a fragment of the allogenic iliac-tibial tract by double wrapping around the tendon and stitching with the seam ribbons. Then, from the standard posterior port, a blunt canal is formed at the level of the blade aft between the deltoid and small round muscles, and an augmented tendon of the latissimus dorsi is inserted through it, followed by fixation in the region of the greater tubercle of the humerus using nodeless anchor fixators.;EFFECT: method provides improved outcomes of the surgical management of the patients with a massive rupture of the posterior-upper part of the rotator cuff of the shoulder joint, when it is impossible to perform a complete suture of the injured tendons and fixation to the anatomical attachment point due to their fatty degeneration and retraction, safety in respect of damage to the neurovascular structures located in close proximity, reduced probability of tendon rupture in postoperative period, faster surgical intervention due to combination of methods of declared method.;1 cl, 13 dwg, 1 tbl, 1 ex