RESULTS OF RADIAL RESEARCH OF PATIENTS WITH SOFT TISSUES DAMAGES OF A HUMERAL JOINT AFTER OPERATIVE TREATMENT

Logvinenko V. V.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Introduction. Despite a considerable quantity of the operative interventions spent on humeral joints, there is a small amount of literary publications on this question. The operated structures of a humeral joint — the shoulder rotator cuff, an articulate labium have the specific image on ultrasonograms, magnetic resonance tomograms, which differs from norm and can be a source of diagnostic errors. Besides, in the postoperative period quite often there are complications which require diagnostics and treatment. Research objective. By means of radial methods of diagnostics to study changes in a humeral joint after operative interventions concerning tears of a rotator cuff of a shoulder, an impingement syndrome, instability of a humeral joint and to investigate complications which arise in the postoperative period. Object and research methods. 71 patient after operation on a humeral joint is surveyed. From them intervention concerning tears of a rotator cuff of a shoulder are executed to 27 patients, a syndrome impingement — 16, instability of a humeral joint — 28 patients. Surgical intervention was spent by open way. Operative access was selected depending on damage localisation. At tears of a rotator cuff of a shoulder, it was spent reinsertion the damaged sinews to a place of their physiological attachment by means of anchors. For elimination a syndrome impingement it was spent acromioplasticitic, a section coracoacromial ligament, and in the presence of sinew tears supraspinatus muscles it was in addition spent it reinsertion to a greater tubercle. At the instability of a humeral joint caused by tears of an articulate labium, fixing to an articulate cavity of a scapula was spent it anchors. In the postoperative period radial researches are spent in volume: roentgenography — 71 (100 %) to the patient, roentgenoscopy — 4 (5,6 %), an ultrasonography — 15 (21,1 %), a computed tomography — 2 (2,8 %), a magnetic resonance imaging — 2 (2,8 %) the patient. Results and their discussion. On roentgenograms after reinsertion sinews of a rotator cuff of a shoulder anchors were defined in greater or small tubercle, and after sewing of tears of an articulate lip in a bone part glenoid scapula. On ultrasonograms patients at whom after interventions on a shoulder rotator cuff, the postoperative period proceeded without the features, the sewn sinews looked a thicker in comparison with not changed sinews of an opposite joint. Echogenicity these sinews was lowered, characteristic fibrillar pattern which is inherent in not changed sinews, did not come to light. 15 persons had complaints to pains in the field of a shoulder and infringement of function of a humeral joint. At 3 patients loss of anchors, from them in two — from a greater tubercle, at one — from an articulate cavity of a scapula is revealed. In 6 patients ultrasonograms signs of repeated tears of a sinew supraspinatus muscles have been found out. At 2 patients on ultrasonograms and magnetic resonance tomograms signs synovitis are revealed. Signs are found out In two patients at functional ultrasonograms an impingement of a syndrome of a humeral joint. At one patient, despite a proof painful syndrome in the field of a shoulder, it is not revealed changes at radial research. Conclusions. Radial research in the postoperative period allows to estimate changes in a humeral joint directly after operative intervention, at rehabilitation stages, and also to reveal complications.

a humeral joint, radial methods of diagnostics, the postoperative period, complications

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«Bulletin of problems biology and medicine» Issue 1 part 1 (126), 2016 year, 185-189 pages, index UDK 616.727.2–001.4/.6–073.75