METHOD FOR TREATING LONG-STANDING DAMAGE TO THE TENDON OF THE PECTORALIS MAJOR MUSCLE Russian patent published in 2021 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely traumatology, and can be used for surgical treatment of long-standing subcutaneous ruptures of the tendon of the pectoralis major muscle. Channels are created in the humerus and fixating elements are passed through said channels. An allotendon is used as a fixating element, one end whereof is passed through the formed vertical channel in the thickness of the pectoralis major muscle at a step of 1.5 to 2 cm from the torn end thereof. For this purpose, a blunt dissection of the retracted tendomuscular section of the pectoralis major muscle is performed in the medial direction, followed by fixating the end of the allotendon on the muscular belly of the pectoralis major muscle. Then dissection is performed laterally, the medial surface of the humerus is exposed at a distance of 4 to 5 cm from the tip of the humeral head. The intertubercular groove with the tendon of the long bicipital head lying therein and laterally from the tendon is visualised. With internal humeral rotation at the level of formation of channels in the humerus, 2 Kirschner wires are passed and 2 channels are formed in the crest of the greater humeral tubercle in the frontal plane at a distance of 1.5 cm between the holes, wherein the lower channel is formed in the horizontal direction and the upper one is formed at an angle of 30 to 40°. The other end of the allotendon in the form of a loop is passed through the formed channels and the incision between the tissues on the outer surface of the shoulder, followed by restoring the necessary muscular tone of the pectoralis major muscle by tensioning the allotendon, wherein the nipple is taken as the reference point. The passed end of the allotendon is sutured to the fixated end of the allotendon.

EFFECT: method reduces the trauma rate of surgical intervention, minimises the risk of intraoperative and postoperative complications, and provides a possibility of early rehabilitation due to the use of mini-access, conservative mobilisation of the damaged tendon from cicatrical adhesions and secure fixation to the outer surface of the humerus.

1 cl, 6 dwg