METHOD FOR SURGICAL MANAGEMENT OF MASSIVE IRREPARABLE INJURIES OF ROTATOR CUFF OF SHOULDER JOINT WITH UNDERLYING ROTATOR ARTHROPATHY OF SHOULDER JOINT Russian patent published in 2024 - IPC A61B17/56 

FIELD: medicine; traumatology; orthopedics.

SUBSTANCE: invention can be used for surgical treatment of patients with massive irreparable rotator cuff injuries accompanied by rotator arthropathy of shoulder joint. Two anteroposterior approaches are performed. Through the first approach, a modeling resection of the lower part of the acromion is performed by 1/3 of its thickness, a contracted rotator cuff of the shoulder joint is inspected, tendon edge is recovered and mobilized and sutured at 4–5 points. Then osteotomy and resection of greater tubercle of humerus is performed, and receiving bed is formed medial to zone of greater tubercle. Through the second approach, a muscular and tendon part of the broadest muscle of back is taken, the free end of which is sutured and moved to the head of the shoulder in the space between the deltoid and small round muscles. Displaced tendon is fixed with a lateral edge transosseously in the receiving bed of the greater tubercle of the humerus. Then tenotomy of long head of biceps is performed from point of attachment to glenoid and sutured "side to side" to tendon graft. After that, a flap is cut out from the infraspinatus tendon, which is moved ventrally and unfolded so that it is sutured "side to side" from the medial side to the edge of the supraspinatus muscle, and the lateral edge of the flap is sutured to the tendon of the long head of the biceps with single interrupted staggered sutures.

EFFECT: method enables restoring the position of the displaced upward and forward of the shoulder head with a significant defect of the rotator cuff of the shoulder joint by moving the proximal fixation point of the tendon of the broadest muscle of back and restoring the continuity of the tendon tissue of the rotator cuff.

1 cl, 15 dwg, 1 ex