SURGICAL APPROACH TO ELIMINATING THE POST-TRAUMATIC INSTABILITY OF THE SHOULDER JOINT
https://doi.org/10.29235/1561-8323-2018-62-3-311-321
Abstract
The results of treatment of 290 patients with chronic post-traumatic instability of the shoulder joint treated for the period 2004–2017 are studied. In accordance with the task, the authors identified 3 clinical variants of post-traumatic instability depending on the prevailing direction of the dislocation. Taking into account the revealed variants, the authors studied their morphogenesis and developed a differentiated tactic and ways of their elimination. The proposed approaches based on the identification and elimination of damages of the rotary-bicepital complex, as well as the developed methods of surgical treatment made it possible to improve the subjective feelings of patients on the OOP scale from 56 [48; 58] to 24 [12; 28] (Me [Q25; Q75]) and indicators of objective evaluation of the function on the Rowe scale from 15 [15; 55] to 75 [75; 100] points.
About the Authors
O. A. Danilenko
Minsk City Clinical Center of Trauma and Orthopedics .
Russian Federation
Russian Federation
Danilenko Oleg Anatolievich – Ph. D. (Medicine), Head of the Department.
6, Uralskaya Str., 220046, Minsk.
E. R. Makarevich
Belarusian State Medical University
Russian Federation
Russian Federation
Makarevich Evgenii Reonaldovich – D. Sc. (Medicine), Professor, Head of the Department.
83, Dzerzhynskiy Ave., 220116, Minsk.
N. S. Serduchenko
National Academy of Sciences of Belarus
Russian Federation
Russian Federation
Serduchenko Nikolai Sergeevich – Corresponding Member, D. Sc. (Medicine), Professor, Academician-Secretary.
66, Nezavisimosti Ave., 220072, Minsk.
References
1. Zacchilli M. A., Owens B. D. Epidemiology of shoulder dislocations presenting to emergency departments in the United States. Journal of Bone and Joint Surgery-American, 2010, vol. 92, no. 3, pp. 542–549. https://doi.org/10.2106/jbjs.i.00450
2. Emond M., Le Sage N., Lavoie A., Rochette L. Clinical factors predicting fractures associated with an anterior shoulder dislocation. Academic Emergency Medicine, 2004, vol. 11, no. 8, pp. 853–858. https://doi.org/10.1197/j.aem.2004.03.009
3. Boone J. L., Arciero R. A. Management of failed instability surgery: how to get it right the next time. Orthopedic Clinics of North America, 2010, vol. 41, no. 3, pp. 367–379. https://doi.org/10.1016/j.ocl.2010.02.009
4. Kroner K., Lind T., Jensen J. The epidemiology of shoulder dislocations. Archives of Orthopaedic and Trauma Surgery, 1989, vol. 108, no. 5, pp. 288–290. https://doi.org/10.1007/bf00932317
5. Robinson C. M., Dobson R. J. Anterior instability of the shoulder after trauma. Journal of Bone and Joint Surgery, 2004, vol. 86, no. 4, pp. 469–479. https://doi.org/10.1302/0301-620x.86b4
6. te Slaa R. L., Wijffels M. P. J. M., Brand R., Marti R. K. The prognosis following acute primary glenohumeral dislocation. Journal of Bone and Joint Surgery. British volume, 2004, vol. 86-B, no. 1, pp. 58–64. https://doi.org/10.1302/0301620x.86b1.13695
7. Skakun P. G. Long-term results of treatment of the shoulder-slip. Travmatologiya i ortopediya: sovremennost’ i budushchee [Traumatology and orthopedics: modern state and future], Moscow, Publishing house of the Russian University of Peoples’ Friendship, 2003, pp. 157–158 (in Russian).
8. Wang R. Y., Arciero R. A., Mazzocca A. D. The recognition and treatment of first-time shoulder dislocation in active individuals. Journal of Orthopaedic & Sports Physical Therapy, 2009, vol. 39, no. 2, pp. 118–123. https://doi.org/10.2519/jospt.2009.2804
9. Bigliani L. U., Kelkar R., Flatow E. L., Pollock R. G., Mow V. C. Glenohumeral stability. Biomechanical properties of passive and active stabilizers. Clinical Orthopaedics and Related Research, 1996, vol. 330, pp. 13–30. https://doi.org/10.1097/00003086-199609000-00003
10. Su W. R., Budoff J. E., Luo Z. P. The effect of posterosuperior rotator cuff tears and biceps loading on glenohumeral translation. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2010, vol. 26, no. 5, pp. 578–586. https://doi.org/10.1016/j.arthro.2009.09.007
11. Flatow E. L., Miniaci A., Evans P. J., Simonian P. T., Warren R. F. Instability of the shoulder: complex problems and failed repairs. The Journal of Bone and Joint Surgery (American Volume), 1998, vol. 80, no. 2, pp. 284–298. https://doi.org/10.2106/00004623-199802000-00016
12. Warner J. J. P., Iannotti J. P., Flatow E. L. Complex and Revision Problems in Shoulder Surgery. Philadelphia, Lippincott Williams and Wilkins, 2005. 669 p.
Review
Views: 980
Email this article 