Zabielin I. Experimental and clinical study of surgical treatment of acute injuries of the acromioclavicular joint

Object: damage ligamentous apparatus of the acromioclavicular joint. Aim: to improve the results of surgical treatment of patients with dislocations of the acromial end of the clavicle by clinical and experimental justification of the restoration of coraco-clavicular ligament under the condition of injuries of the acromioclavicular joint. Methods: clinical, experimental, X-ray, mathematical modeling, analysis of restoration of function of the shoulder joint with use of a scale Constant, statistical. First time on the cadaverous material the role of certain structures of acromioclavicular joint has been established under the normal condition, injuries and after surgical repair. Obtaining new data on spatial relationships of the ligamentous apparatus of the acromioclavicular joint at his injuries allowed to develop a technique of minimally invasive treatment of injuries acromioclavicular joint by minimally invasive manner. On the basis of developed fixing device for the surgical stabilization of the dislocations of the acromial end of the clavicle was obtained (patent of Ukraine № 62957). First time computational model acromioclavicular joint has been developed. This model allows us to determine the optimum point fixing clamp on the collarbone to restore the coraco-clavicular ligament. During the experimental research new information about the strength of fixation of the acromioclavicular joint with the proposed method of surgical treatment was obtained. First time the method of fixing the acromial end of the clavicle in its dislocations has been developed and introduced into clinical practice (patent of Ukraine № 82256). His strength is greater than the native ligament acromioclavicular joint at 21.6%. Developed a new fixing device for the treatment of dislocations of the acromial end of the clavicle can restore anatomical and biomechanical characteristics of the acromioclavicular joint. A technique that allows to reduce the trauma surgery and improve outcomes in patients with lesions of the acromioclavicular joint, has been developed. The proposed method of treatment of acromioclavicular joint injuries in the conditions of small trauma surgery and reliable fixation acromial end of the clavicle allows to provide rapid recovery of limb function and shorten the period of temporary disability. Experimental substantiation and results of clinical studies have confirmed the effectiveness of the proposed method of surgery and a application of active approach to postoperative treatment of patients. Substantiated active tactics of postoperative and rehabilitative treatment allowed to achieve high efficiency of treatment (excellent and good results in 97.7 % of patients). The study of long-term follow-up results confirmed the efficacy of the device and methods for restoring the acromioclavicular joint due to a significant increase in the reliability of its recovery. The results of studies introduced into clinical practice of SI "Sytenkо Institute of Spine and Joints Pathology National Academy of Medical Sciences of Ukraine", KZOZ "Kharkiv Regional Clinical Hospital - Center of emergency medical care and disaster medicine" KU "Zaporizhzhya Regional Hospital," Zaporizhzhya Regional Council, KU "Odessa Regional Hospital", SI "Institute of traumatology and orthopaedics National Academy of Medical Sciences of Ukraine". Traumatology and Orthopaedics.