METHOD FOR SHOULDER REPLACEMENT AND SCAPULA REPLACEMENT AFTER COMPLETE REMOVAL OF SCAPULA Russian patent published in 2024 - IPC A61B17/56 A61F2/40 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery and oncology, and can be used for scapula and shoulder joint replacement. Method includes cutting off muscles and tendons in places of their attachment to scapula, coracoid process, and around acromioclavicular joint, dissection of the acromioclavicular joint and the capsule of the shoulder joint, after which the scapula is removed, the individually made endoprosthesis of the scapula is inserted with the required anatomical and physiological orientation and checking for movements, after which the resected muscles and tendons are sequentially sutured, restoring the muscular architectonics of the shoulder girdle. Posterior surface of the shoulder is incised from a lower angle of the scapula upwards, along a projection of a medial edge of the scapula, to a clavicular-acromial joint. Humeral head is resected at the level of an anatomical neck at angle of 45 degrees to a long axis of the humerus. Medullary canal of the humerus is dilated. Humeral endoprosthesis is additionally provided with a humeral crus inserted into the prepared medullary canal of the humerus and fixed. Additional fixation of the shoulder joint is carried out by connecting the acromial end of the clavicle with the joint assembly of the endoprosthesis. Leg of the humeral component of the endoprosthesis is cemented in the medullary canal of the humerus. Acromial end of the clavicle is connected to the joint assembly of the endoprosthesis with the help of nylon sutures through holes drilled in the acromial end of the clavicle.

EFFECT: method provides wider indications for endoprosthesis replacement of the scapula with its tumour and precancerous lesions, enables to perform complete removal of the scapula in a single block, without violating the integrity of the tumour, eliminates dislocations and subluxations of the head of the humerus, reduces the length of rehabilitation, improves the quality of life of the patient, with a good cosmetic result due to the possibility of reconstructing the muscular architectonics of the shoulder girdle in accordance with the anatomical and physiological principles of antagonism and performing the complete removal of the scapula in a single block without disturbing the integrity of the tumour.

3 cl, 1 ex