FIELD: medicine; traumatology; orthopaedics.
SUBSTANCE: invention can be used to treat patients with a massive, irreparable anterior-superior rupture of the rotator cuff of the shoulder joint. Through an additional suprapectoral arthroscopic port and an additional instrumental lateral suprapectoral port, using tissue hydropreparation, the tendon of the latissimus dorsi muscle is cut off at the site of attachment on the crest of the lesser tubercle of the humerus. A Foley balloon catheter is installed and inflated in the region of the edge of the cut off tendon of the latissimus dorsi muscle. An inflated balloon Foley catheter and a severed tendon of the latissimus dorsi muscle are visualized through the axillary surgical access, which is brought out through the surgical wound and augmented with a fragment of the allogeneic dura mater by wrapping it twice around the tendon of the latissimus dorsi muscle and suturing with suture tapes. The free ends of the tapes are fixed to the ear of the Foley catheter, and then the augmented tendon of the latissimus dorsi muscle is passed through the specified catheter into the anterior subdeltoid space, followed by its fixation in the region of the lesser tubercle of the humerus using anchor fixators.
EFFECT: method provides improved outcomes of surgical treatment of patients with a massive rupture of the anterior-upper part of the rotator cuff of the shoulder joint, when it is impossible to perform a full-fledged suture of the damaged tendons and fixation to the place of anatomical attachment due to their fatty degeneration and retraction; reducing the risk of complications associated with the use of controlled hypotension; safety in relation to damage to the neurovascular structures located in the immediate vicinity; reducing the probability of tendon rupture in the postoperative period; reducing the time of surgical intervention by creating additional ports, installing a Foley balloon catheter from the anterior arthroscopic port, followed by its inflation in the area of the latissimus dorsi tendon and augmentation of the latissimus dorsi tendon.
1 cl, 10 dwg, 1 tbl, 1 ex
