METHOD FOR EVALUATING THE INTERACTION OF SHOULDER JOINT ARTICULAR SURFACE DEFECTS AT PLANNING OF SURGICAL TREATMENT OF ANTERIOR INSTABILITY

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used to assess the interaction of defects in articular surfaces of the shoulder joint when planning surgical treatment of anterior instability by CT. Perform simultaneous scanning of both shoulder joints in the position of the patient lying on back, hands along the trunk with a slice thickness of 0.5 mm. After evaluating the joint structures on the axial sections, three-dimensional VRT-reconstructions of both shoulder joints are constructed, and an estimate of the width of the Hill-Sachs defect (D_X-S) are measured by measuring the distance between the most distant points of the tendon attachment line of the rotator cuff of the shoulder and the inner edge of the bone defect. Then, in the postprocessing, the image of the heads of the humerus is removed, and the reconstructions obtained are deliver in a plane parallel to the articular surfaces of the shoulder blades. Measure the transverse dimensions of the articular process of the shoulder blade (APSB) of the injured (I_j) and uninjured joint or joint before injury (UI_j). Draw a vertical line from the supraglenoid tubercle to the lower edge of the glenoid cavity, and the measurement of the transverse dimension of the APSB is performed perpendicular to the obtained line in the widest diameter of the APSB. In the case of injury to the APSB of both joints for the determination of UI_j on the image of APSB, draw a regular circle along the back and bottom edges of the APSB and the diameter of this circle will correspond to UI_j. Calculate the APSB path of the injured joint according to the formula "Lane of the APSB of the injured joint" = 0.83*UI_j-(UI_j-I_j)=I_j-0.17*UI_j. To estimate the interaction of joint surface defects, the coefficient K of the ratio of the APSB path of the injured joint to the width of the Hill-Sachs defect (D_X-S) using formula . At the coefficient K≤1, patients are supplemented by surgery in the form of a Bankart operation or a Bristow-Latarjet operation by the procedure of capsulodesis and tenodesis of the infraspinatus muscle to the Hill-Sachs defect area.;EFFECT: invention makes it possible to reduce the number of postoperative relapses, pain syndrome and contractures.;1 cl, 6 dwg, 1 tbl, 2 ex