METHOD FOR REPAIRING A COMPLETE RUPTURE OF THE DISTAL TENDON OF THE BICEPS BRACHII Russian patent published in 2022 - IPC A61B17/00 A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics, and can be used to repair a complete rupture of the distal tendon of the biceps brachii. The patient is placed in the supine position with the arm abducted at 90° in the shoulder joint, the operated limb is in the position of supination of the forearm and with full extension of the elbow joint. With a guide needle, marking is made on the palmar surface of the forearm in the projection of the tuberosity of the radius, applying it to the skin. A transverse skin incision is made on the palmar surface of the forearm in the projection of the tuberosity of the radius at the marking site. The guide pin is drilled into the upper edge of the visualized tuberosity of the radius through and through. Drilling is performed along the guide wire in the upper edge of the tuberosity of the radius with the formation of the first through channel, then, retreating distally by 2 cm, which corresponds to the lower edge of the tuberosity of the radius, the second guide wire is drilled through, drilling is performed along the guide wire in the lower edge tuberosity of the radius with the formation of the second through channel. The cortical layer is reamed in the tuberosity of the radius, forming a non-through oval hole that unites the first through channel on the upper edge of the tuberosity of the radius and the second through channel on the lower edge of the tuberosity of the radius. In the lower third of the shoulder proximal to the area of ​​the elbow above the area of ​​the retracted distal tendon of the biceps brachii, a longitudinal skin incision is made and the stump of the distal tendon of the biceps of the shoulder is isolated, which is sutured with the first thread, leaving its ends free. The first cortical button is installed on the free ends of the thread with the formation of a self-tightening loop, the free ends of the first thread are led out through the second channel from the longitudinal skin incision to the transverse skin incision. A second non-absorbable thread is introduced into the second cortical button with the formation of a self-tightening loop, leaving its ends free. Through the transverse skin incision, the second cortical button is inserted in a vertical position, passed through the first through channel in the cortical layer outwards, while the free ends of the second thread remain brought out in the transverse skin incision. The first cortical button is inserted in a vertical position through the second through channel in the cortical layer outward. Both cortical buttons are transferred from the vertical to the horizontal position, the elbow joint of the operated limb is brought into the flexion position. Through a transverse skin incision, self-tightening loops on cortical buttons are pulled by tensioning their free ends and the resulting tension is fixed by making locking knots at the free ends of the threads, plunging the stump of the distal tendon of the biceps brachii muscle into the non-through oval hole of the tuberosity of the radius.

EFFECT: method provides reducing the risk of tendon re-rupture, very low, rigid fixation of the tendon, low probability of injury to a number of passing anatomical formations of the peripheral nervous and vascular systems, soft tissues and reduction of rehabilitation time due to the high area of tendon osseointegration with this type of cortical fixation, the formation of an oval hole in projections of the native pattern - tuberosity of the radius, the use of two cortical buttons and execution through minimally invasive approaches.

1 cl, 12 dwg, 1 ex