METHOD FOR TREATMENT OF MASSIVE RUPTURE OF SUPRASPINATUS TENDON

摘要

FIELD: medicine; traumatology; orthopedics.;SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics; it can be used for the treatment of a massive rupture of the supraspinatus tendon. A method includes access to the shoulder joint, refreshing the insertion site of the humerus, access to the tendon of the widest muscle and its dissection, cutting off the tendon of the widest back muscle from the humerus, stitching the severed tendon stump, forming a channel under the posterior portion of the deltoid muscle and transposition of the tendon of the widest back muscle through the formed channel to the prepared insertion site of the humerus, and insertion of the tendon of the widest muscle on the head of the humerus with transosseous sutures. The severed tendon of the widest muscle is folded twice lengthwise and stitched with non-absorbable suture material, leaving free threads at the end. In the large tubercle of the humerus of the prepared insertion site, a blind channel is formed with a depth of 2.0 cm and a diameter corresponding to the diameter of the stitched tendon autograft. The stitched part of the tendon autograft of the widest back muscle is immersed into the formed blind canal. The autograft at the input to the channel is fixed with a screw. Free ends of threads are brought out and tied. The stitched part of the tendon autograft is fixed with a screw at the input to the channel, and the free part of the tendon is fixed to the humerus with transosseous sutures. The distance from the upper pole of the glenoid to the large humerus tubercle is measured, after which a linear incision is made along the outer surface of the thigh, and a tape is taken from the wide fascia of the thigh with a width of 3 cm and a length equal to three times the distance from the upper pole of the glenoid to the humerus tubercle. Then the defect of the wide fascia of the thigh is sutured with a continuous absorbable suture, and the fascial autograft is folded three times in length and stitched at corners with non-absorbable suture material. One end of the stitched fascial autograft is fixed to the upper pole of the glenoid, and the second end is fixed to the large tubercle of the humerus, on the fixed tendon. ;EFFECT: method provides an increase in the effectiveness of treatment of massive inoperable ruptures of the supraspinatus tendon, its stable and reliable fixation, eliminates the possibility of proximal subluxation in the shoulder joint and restoration of its function by increasing the strength of the autograft.;1 cl, 1 dwg, 2 tbl, 1 ex