METHOD OF SURGICAL TREATMENT OF POSTERIOR INSTABILITY OF SHOULDER JOINT IN PATIENTS WITH SPASTIC PARALYSIS OF UPPER EXTREMITIES Russian patent published in 2020 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to orthopaedics, and can be used for reconstructive surgical treatment of patients with spastic paralysis accompanying development of combined contracture, deformation of shoulder girdle due to increased traction of extensors and internal rotators of shoulder. Bone autograft is separated from blade root on constant muscular pedicle of posterior portion of deltoid muscle. Further, the point of fixation of tendons of the broadest muscle of the back and the greater round muscle together with the portion of the humerus cortical plate is selected. Projection of the posterior edge of the articular process of the blade is provided with a window in external rotators of the shoulder, through which a receiving bone bed is prepared in the zone of the defect of an articular process. In this bone bed, and an autograft is installed from the blade root with the end face so that the base of the separated blade spine fragment lies on the wound surface on the posterior edge of the articular process, and the body of the bone autograft is an extension of the articular surface of the articular process, after which the autograft is fixed with screws or spokes. On the surface of a greater humerus of a humerus forming a receiving bone bed and fixed to it by an anchor fixator an earlier section of a humeral cortical plate with tendons of the latissimus muscle of the back and a large round muscle attached to it in a position of external rotation of the shoulder. If necessary, additionally fixing a distal part of the tendon of the broadest muscle of the pin and the greater round muscle to the tendons of the external rotators of the shoulder. There can also be isolated use for transposition of only the latissimus muscle of back or large round muscle.

EFFECT: method provides higher stability of the injured shoulder joint by forming a bone block of sufficient height with simultaneous weakening of the pathological muscular thrust aimed at formation of posterior dislocation.

4 cl, 7 dwg, 2 ex