FIELD: medicine; surgery.
SUBSTANCE: method involves lavsan tape passing through the channels formed in humerus metaepiphysis and coracoid process with following connection of tape ends. Channels are formed after muscles are bluntly exfoliated from joint capsule thus not removing bone tissue, with pricking at maximum external humeral head rotation entoectad. In coracoid process, the channel is formed entoectad from within providing axial inclination at the angle 30-45° to horizon. In humerus metaepiphysis, the channel is formed under middle third of small tubercle from both points of channel rising with segments inwards from the outside to provide their mutual crossing in metaepiphysis. Lavsan tape with spontaneous path crossing and cross point contact is passed through formed channels and followed with internal rotation with shoulder adduction to the trunk. After the tape is tightened, its ends are tied up herewith controlling motion in shoulder joint. If motion is not limited, at least two tight knots are added. After the tape is tightened to its free ends, tape cross point is sewed in duplication to joint capsule as high as possible. Joint capsule is approached through skin and subcutaneous fat incision from coracoid process downwards through delta pectoral sulcus to muscular part of a biceps with following fascia dissection. While the tape is passed through formed channels, its first path is positioned branch between output hole of the channel provided in coracoid process and the hole of the channel formed under small tubercle along the shoulder anatomic neck line. Herewith the second path is positioned between input hole of the channel formed in coracoid process and the hole of the channel formed under small tubercle in intertubercular sulcus. Furthermore the first path of lavsan tapes lays on the second one. Adduced limb is immobilised 3 weeks with elbow joint 90° bent with using Desault removable plaster bandage.
EFFECT: maintained complete mobility of humerus in joint and retention of humerus head, preventing possibility of humerus head encroachment from contacting articular surface, provided high-strength barrier within anterointernal part of joint capsule.
3 cl, 1 ex, 4 dwg
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Authors
Dates
2009-03-10—Published
2007-09-19—Filed