METHOD OF ARTHROSCOPIC AUTOPLASTY OF ARTICULAR PROCESS OF SCAPULA WITH ANTERIOR INSTABILITY OF SHOULDER JOINT

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, in particular to traumatology and orthopedics, and can be used in treating patients with chronic forms of anterior recurrent instability of the shoulder joint, characterized by the presence of adjoining defects of articular process of the scapula and head of humerus. Arthroscopic transposition of the osteotomized fragment of the coracoid process of scapula into the bone tissue defect on the anterior surface of the articular process of the scapula with its subsequent fixation by screws through the pre-drilled canals in both matched bone formations is performed from three arthroscopic ports and additionally forming a suprapectoral, lower anterolateral, medial, supracoracoid and additional posterior arthroscopic ports. Preparation of an implant bone site is performed, a splint is formed through the whole thickness of the subscapular muscle between its upper and middle thirds in the lateral direction of the combined tendon of the short head of biceps and coracohumeral muscle. Osteotomy of the coracoid process of the scapula is performed; then an osteotomous fragment of the coracoid process of the scapula is brought out through the additional medial port on the front surface of the thorax and two parallel channels are formed in it. First element of the guide is installed so that its hook-shaped working part is hooked and immobilized the above articular process. Second component of the guide is installed through an additional posterior port and two parallel channels are formed with the help of the patient in the area of the prepared implant bone site. Flexible conductors are delivered through parallel bone channels formed in the articular process of the scapula and a pre-cleavage in the subscapular muscle. Osteotomous fragment of the coracoid process of the scapula is placed on the conductors, passing through the bone channels, displaced into the area of the prepared implant bone site and fixed in the optimal position with two cannulated screws.;EFFECT: method enables reducing the risk of resorption of the scapula coracoid process bone block by transposition and developing deforming arthrosis of the shoulder joint due to its strong and safe fixation to the articular process of the scapula in the optimal position, reduced risk of intraoperative neurological complications due to rear drilling technique when forming bone ducts in articular process of scapula, possibility of arthroscopic visual inspection of all stages of operation and intraoperative correction of accompanying anatomical damages due to formation of additional arthroscopic ports.;1 cl, 15 dwg, 1 ex