METHOD FOR MINIMALLY INVASIVE SURGICAL APPROACH IN REVERSE SHOULDER JOINT ENDOPROSTHESIS REPLACEMENT

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to traumatology and orthopedics, and can be used in reverse shoulder joint endoprosthesis replacement. Preoperative examination is performed. Then, in a sitting position on an operating table with an angle between the patient's body and hips of 90° and with a roller in the popliteal region, an incision of the skin and subcutaneous fat of 5.0–5.9 cm is made from the edge of the acromion linearly along the outer surface of the shoulder in the distal direction to the level of the projection of the greater tubercle. Further, deltoid muscle is approached, front and middle bundles of deltoid muscles are bluntly separated, humeral head is mobilized with preliminary suturing and preservation of tendons of shoulder rotator muscles. Then shoulder is rotated outwards by 25–35°, dislocated along axis of humerus in proximal direction with bent by 90° forearm and performing dislocation and removal of proximal metaepiphysis of shoulder in wound for subsequent sawing of head of humerus and treatment of humerus and shoulder blade when performing reverse shoulder replacement.;EFFECT: method allows to reduce surgical aggression and tissue injury, prevents occurrence of postoperative pyoinflammatory complications, provides anatomical restoration of shape and anatomical function of shoulder joint structures, prevents iatrogenic damage to axillary nerve and veins with arteries enveloping head of humerus, and also provides reducing the length of hospitalization of the patient with simultaneous sufficient improvement of the quality of his/her life.;1 cl, 3 ex