Traumatology and Orthopedics of RussiaTraumatology and Orthopedics of RussiaТравматология и ортопедия России2311-29052542-0933Vreden National Medical Research Center of Traumatology and Orthopedics6610.21823/2311-2905-66EXPERIENCE EXCHANGEОБМЕН ОПЫТОМExperience exchangeUnknownRESULTS OF SHOULDER STABILIZATION BY A MODIFIED BRISTOW - LATARJET PROCEDURE WITH ARTHROSCOPYРЕЗУЛЬТАТЫ СТАБИЛИЗАЦИИ ПЛЕЧЕВОГО СУСТАВА ПО МОДИФИЦИРОВАННОЙ МЕТОДИКЕ БРИСТОУ - ЛАТАРЖЕ С АРТРОСКОПИЧЕСКИМ СОПРОВОЖДЕНИЕМGladkovR. V.ГладковР. В.
Russian Federation
dr.gladkov@gmail.comRikunO. V.РикунО. В.
Russian Federation
rikoleg@yandex.ruAverkievD. V.АверкиевД. В.
Russian Federation
averdm@mail.ruGrankinA. S.ГранкинА. С.
Russian Federation
aleksey-grankin@yandex.ruKirov Military Medical AcademyФГБВОУ ВПО «Военно-медицинская академия им. С.М. Кирова» МО РФ12092014202859212092016Copyright ©; 2014,Copyright ©; 2014,2014https://journal.rniito.org/jour/article/view/66

The authors describe the minimally invasive technique for Bristow-Latarjet bone unfree autoplasty with arthroscopy in patients with bone loss more than 25% of anterior-posterior diameter of the glenoid, the poor quality of the capsule or deep defects of Hill-Sachs. The analysis of the early results of treatment in 19 patients and midterm results - in 13 soldiers operated in 2011-2014. Features of the proposed technique are the shortening of surgical approach and the reduction of subscapularis muscle damage. In addition, arthroscopic support allows to attain the precision location of the graft relative to the articular surface of scapula, at the same time restoring the damaged anatomy SLAP, rotator cuff tendons and posterior labrum and restore shoulder ligaments tension and isolate bone graft from the joint cavity, contributing to a better articulation of the humeral head and reducing the risk of nonunion and resorption.

Предложена минимально инвазивная методика несвободной костной аутопластики по Бристоу - Латарже с эндовидеоскопическим сопровождением при дефиците суставной поверхности более 25% передне-заднего диаметра гленоида, рубцовом истончении капсулы или глубоких дефектах головки плечевой кости. Проведен комплексный анализ ближайших результатов лечения у 19 и среднесрочных - у 13 военнослужащих, оперированных в 2011-2014 гг. Особенностями предложенной методики является уменьшение размера хирургического доступа и степени повреждения подлопаточной мышцы при выполнении ее разделения. Кроме того, артроскопическое сопровождение позволяет добиться прецизионности расположения трансплантата относительно суставной поверхности лопатки и изолировать костный трансплантат от полости сустава, что способствует лучшей артикуляции головки плечевой кости и уменьшает риск его несращения и резорбции. Методика также позволяет одновременно восстанавливать анатомию поврежденных биципито-лабрального комплекса, сухожилий вращающей манжеты плеча и задней суставной губы лопатки, а также восстанавливать натяжение суставно-плечевых связок.

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