Застарелое повреждение мышц надплечья и вращательной манжеты плеча: клинический кейс миофасциальной транспозиции

Abstract

Introduction A case of a successful surgical treatment of a neglected injury of the upper arm muscles and rotator cuff in a working-age man with a history of an episode of thromboembolism of small branches of the pulmonary artery is presented. The aim of this study was to demonstrate one of the approaches to surgical treatment of this pathology that resulted in the improvement of upper limb function and the quality of life of the patient. Material and methods A comprehensive study of the patient's outpatient and inpatient records, results of clinical, instrumental and laboratory methods, the types of intervention and rehabilitation along with medical prevention of thrombosis are described in detail. Results Eight months after the surgery, there was an improvement in the function of the right shoulder joint. The range of active motion significantly increased; the DASH score decreased from 136 to 52 points; pain decreased from 46 to 31 points according to VAS; the level of self-service significantly improved. Discussion Сombined techniques of preserved muscle transposition to replace the lost function of the damaged ones was a condition and a guarantee of the achieving significant progress in the anatomical and functional status of the patient. Nevertheless, a further search for more rational technologies for restorative reconstruction in the disorders under consideration seems appropriate. Conclusion A correctly chosen and based on clinical and instrumental data transposition of the tendons of the active muscles of the shoulder joint area to replace the lost shoulder antagonists provides improvement of the upper arm function and patients’ quality of life while the justified tactics of thromboprophylaxis allows control of hemostasis and absence of vascular failures.