METHOD FOR DETERMINING THE TACTICS OF MANAGING PATIENTS WITH INCOMPLETE RUPTURES OF THE ROTATOR CUFF OF THE SHOULDER JOINT Russian patent published in 2020 - IPC A61B6/00 A61B5/55 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to traumatology and orthopedics and can be used to determine the management approach to patients with incomplete ruptures of the rotator cuff of the shoulder joint. Patient is followed with X-ray image of a shoulder joint in a straight, lateral and Y-shaped projections, as well as an MRI of a shoulder joint. Tests are carried out: "full can", "empty can", "Neer", wherein positive test result is evaluated as "1", negative test as "0". That is followed by determining presence or absence of: reducing subacute muscle strength; presence or absence of bursal type of rupture, absence or presence of suppressing force of supraspinous muscle, presence or absence of rupture of degree 2 according to Ellman, presence or absence of Ellman 3 rupture, presence or absence of incomplete fracture of the subscapular muscle tendon from the articular surface, presence or absence of central localization rupture. Absence of a feature is evaluated as "0", presence – "1". Then, all input data are added to logistic regression formula:

• e is base of natural logarithm; • ρ is the probability that an event of interest will occur; • β₀, β₁, … β₁₀ – logistic regression coefficients; • x₁ is "full can" test; • x₂ is the "empty can" test; • x₃ – presence or absence of reduction of subacute muscle force; • x₄ – "Neer" test; • x₅ – presence or absence of bursal type of rupture; • x₆ – presence or absence of suppressive force reduction; • x₇ – presence or absence of grade 2 rupture by Ellman; • x₈ – presence or absence of grade 3 rupture by Ellman; • x₉ – presence or absence of incomplete layer rupture of the subscapular muscle of the articular surface; • x₁₀ – presence or absence of central localization rupture. Further, result of p(x) is transformed through function σ(x). When obtaining result σ(x)=1 and without factors such as value CSA>35°, 2-3 degree of Ellman rupture according to MRI data, tenosynovitis of tendon is long: head of biceps muscle according to MRI, reduction of supraspinous muscle by results of clinical examination of patient with any type of rupture is directed to conservative treatment. At σ(x)=1 and detecting at least one of the following factors: angle CSA>35°, 2-3 degree of Ellman rupture according to MRI data, tenosynovitis of tendon of long head of biceps muscle according to MRT, reduction of supraspinous muscle by results of clinical examination, and detection of intraarticular type of rupture or interstitial rupture in nonprofessional sportsman of patient is directed for conservative treatment. If (x)=1 and detecting at least one of the following factors: angle of CSA>35°, 2-3 degree of Ellman rupture by MRI, tendon synovitis of the long head of biceps brachial muscle by MRI, reduction of supraspinous muscle strength by results of clinical examination, and if observing a rupture on the side of subacromial space of the patient is directed for surgical treatment. If σ(x)=0, the patient is referred for primary surgical treatment.

EFFECT: method provides optimizing the choice of the therapeutic approach for incomplete ruptures of the rotary cuff depending on localization, type of ruptures, clinical and X-ray factors.

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