Клиническая практика (Nov 2024)
Clinical case of a new method for the operative treatment of a reversible fracture of a Hill–Sachs
Abstract
BACKGROUND: The posterior dislocation of the humerus head occurs up to 4.5% of all cases of dislocated humerus. Low prevalence and difficulties in diagnosing this type of injury often lead to the formation of old shoulder dislocations. Old cases of back dislocation of the humerus head, especially with reversible bone defects, are accompanied by limitations of movement in the shoulder joint, expressed by pain syndrome. The presence of bone defects in the head of the humerus makes it necessary to replace the latter with bone or soft tissue structures, in surgical practice tendons of the subcutaneous and sub-carpal muscles are most often used. In old cases, scar post-traumatic rebirth is often impossible. CLINICAL CASE DESCRIPTION: The article presents a new method of operative treatment of the old clutch, in the framework of which the use of a new method of operative treatment of the reversal fracture of Hill-Sachs with a long-term stuck back dislocation of the shoulder is considered. The main goal, which is the operative treatment of reversible osteochondral defect up to 25% of the area of the humerus head, due to the deficiency of bone mass of the shoulder head. By moving the corrugated tendon of the long head of the bicep to the impaction zone and fixing it with anchor clamps in the defect zone, resulting in the stabilization of the shoulder joint. CONCLUSION: The outcome of this clinical case is restoration of the function of the shoulder joint and absence of clinical symptoms of instability in it in the late postoperative period. The use of the proposed method of operative treatment makes it possible to reduce the risks of developing postoperative restriction of movements in the joint, instability of the head of the humerus bone, especially in the long-term cases of dislocation of the head of the humerus.
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