RU2598762C1 - Method for surgical treatment of chronic gap of acromioclavicular joint - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, particularly to traumatology and orthopedics. Vertical channel in clavicle is made near its head. Two strong threads, folded twice, a drawn through it, their free ends are drawn in subosseous tissues under the clavicle-acromion joint, swept over them and tied to each other with maximum tension at full adaptation of joint ends. In addition needle is inserted through acromion and clavicle.

EFFECT: method is simple and enables effective treatment of chronic damages of acromioclavicular joint.

1 cl, 1 ex, 4 dwg

Description

The invention relates to medicine, namely to traumatology and orthopedics, and can be used in the treatment of chronic lesions of the clavicular-acromial joint.

Known methods of treating this damage, the essence of which is to keep the clavicle in an acromion-adapted position by using lavsan tape for fixation (methods of Bennel, Kaplan, Chernov et al.), With the aim of forming an acromioclavicular and clavicular-clavicular ligament, as well as methods consisting in the use of metal clips (plates, screws, wire and even Ilizarov apparatus).

Closest to our proposal is the method of Chernov et al. (patent No. 2138217), which we take as a prototype. This method consists in forming two narrow vertical channels in the collarbone through which ligatures are held to fix the mylar ribbon, and additionally fix it through periosteal sutures.

A method for surgical treatment of chronic damage to the clavicular-acromial joint is proposed, which consists in fixing it with a strong duplicate thread held in the vertical channel of the clavicle, near its head, the free ends of which are led out over the acromion in the subossal tunnels and fixed (in the position of adaptation of the clavicle to the acromion) to the initial ends of the threads. Additionally, through the acromion and collarbone carry a safety spoke for up to 3-4 weeks.

The implementation of the method. It is enough in the clavicle, near its head, to draw one vertical channel, bring out a strong duplicate thread through it, bring its ends through the subossal tissues under the acromion, overwhelm them above it and link it with maximum tension to the initial end of the thread loop. Additionally, for insurance, one spoke is made through the acromion and collarbone for up to 3-4 weeks.

The method is not only simple, but also economical due to the relative short duration and lower material costs.

An example of a specific use. Patient A.X., 25 years old, was admitted to the injury department of the 3rd GB 01/17/14 with a diagnosis of a chronic rupture of the right clavicular-acromial joint. The department practiced a method of fixing the clavicular-acromial joint with a special plate, which was not available, and ordering it took some time. With the consent of the patient, it was decided to carry out the operation according to our proposal. 01/20/14, the S-shaped incision exposed the clavicular-acromial joint, near the head of the clavicle a vertical channel was formed with a drill 2 mm in diameter. Through the hole formed, two strong double-sided vikril threads are folded from top to bottom, their free ends in the subossal canals are stretched under the clavicle-acromial articulation and overlapped above the acromion, then they are drawn into the initial thread loop and with maximum tension (with full adaptation of the articular ends of the articulation) between themselves. In addition, for insurance, Kirschner’s spoke was drawn through the acromion and collarbone, the wound was sutured in layers tightly. Operation time 30 min.

The postoperative period was uneventful. Sutures were removed on the 12th day. The spoke is removed after 4 weeks. Discharged home with a recommendation to conduct thermal procedures in the area of surgical intervention and exercise therapy. Examined after 3, 6 and 12 months. There are no complaints. The shoulder function is complete. There are no R-logical signs of displacement of the clavicle in the operated joint.

The stages of the operation are presented in Fig. 1-4.

Subsequently, another 3 patients with similar injuries were operated in the same way. The results of these interventions are also successful.

Literature

1. Patent No. 2138217. Authors: Chernov A.P., Stukolov B.C., Zaitsev R.V.

2. Movshovich I.A. "Operational orthopedics." Medgiz, Moscow, 1984, p. 64-68.

Claims (1)

A method for the surgical treatment of chronic ruptures of the clavicle-acromial joint, which consists in the fact that a vertical channel is formed in the clavicle near its head, two strong threads are folded through it, folded in half, their free ends are carried out in subossal tissues under the clavicular-acromial joint, overwhelmed above it and with maximum tension, with full adaptation of the articular ends, they are tied together, an additional needle is drawn through the acromion and collarbone.

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