spracticeХирургическая практикаSurgical practice (Russia)2223-2427АНО "Консорциум "Медицинская техника"10.38181/2223-2427-2023-4-6spractice-430Research ArticleТРАВМАТОЛОГИЯ И ОРТОПЕДИЯTRAUMATOLOGY AND ORTHOPEDICSПерипротезные переломы у пациентов с последствиями травм плечевого суставаPeriprosthetic fractures in patients with consequences of shoulder joint traumashttps://orcid.org/0000-0002-6680-9334ЕгиазарянК. А.EgiazaryanK. A.

Карен Альбертович Егиазарян, доктор медицинских наук, профессор, заведующий кафедрой травматологии, ортопедии и военно-полевой хирургии

117997, Москва, ул. Островитянова, 1

Prof. Karen A. Egiazaryan, Head of the Department of Traumatology, Orthopedics and Military Field Surgery

1, Ostrovitianova St., Moscow, 117997

egkar@mail.ruhttps://orcid.org/0000-0001-7005-2752ЕршовД. С.ErshovD. S.

Дмитрий Сергеевич Ершов, кандидат медицинских наук, доцент, заведующий учебной частью кафедры травматологии, ортопедии и военно-полевой хирургии

117997, Москва, ул. Островитянова, 1

Dmitry S. Ershov, Education Head of the Department of Traumatology, Orthopedics and Military Field Surgery

1, Ostrovitianova St., Moscow, 117997

ershov0808@gmail.comhttps://orcid.org/0000-0001-5264-7031МиленинО. Н.MileninO. N.

Олег Николаевич Миленин, кандидат медицинских наук, доцент кафедры травматологии, ортопедии и военно-полевой хирургии

117997, Москва, ул. Островитянова, 1

Dr. Oleg N. Milenin, Associate Professor, the Department of Traumatology, Orthopedics and Military Field Surgery

1, Ostrovitianova St., Moscow, 117997

olegmilenin@yandex.ruhttps://orcid.org/0009-0000-7596-4638ПиманчевО. В.PimanchevO. V.

Олег Вячеславович Пиманчев, кандидат медицинских наук, заведующий кафедрой травматологии и ортопедии

105203, Россия, Москва, ул. Нижняя Первомайская, 65

Oleg V. Pimanchev, Head of the Department of Traumatology and Orthopedics

65, Nizhnyaya Pervomayskaya St., Moscow, 105203

pimanchevov@pirogov-center.ruhttps://orcid.org/0000-0001-8002-0260КондыревН. М.KondyrevN. M.

Николай Михайлович Кондырев, ассистент кафедры травматологии, ортопедии и военно-полевой хирургии

117997, Москва, ул. Островитянова, 1

Nikolaj M. Kondyrev, Assistant, the Department of Traumatology, Orthopedics and Military Field Surgery

1, Ostrovitianova St., Moscow, 117997

nkondyrev@gmail.comhttps://orcid.org/0000-0003-3497-5933БадриевД. А.BadrievD. A.

Денис Айдарович Бадриев, ассистент кафедры травматологии, ортопедии и военно-полевой хирургии

117997, Москва, ул. Островитянова, 1

Denis A. Badriev, Assistant, the Department of Traumatology, Orthopedics and Military Field Surgery

1, Ostrovitianova St., Moscow, 117997

ill1dan@mail.ruhttps://orcid.org/0009-0007-0390-3714РафиковВ. О.RafikovV. O.

Владимир Олегович Рафиков, лаборант кафедры травматологии, ортопедии и военно-полевой хирургии

117997, Москва, ул. Островитянова, 1

Vladimir O. Rafikov, Laboratory assistant, the Department of Traumatology, Orthopedics and Military Field Surgery

1, Ostrovitianova St., Moscow, 117997

vladimir.raficov@yandex.ruРоссийский национальный исследовательский медицинский университет имени Н. И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian FederationНациональный медико-хирургический Центр имени Н. И. ПироговаРоссияNational Medical and Surgical Center named after N. I. PirogovRussian Federation202326122023046880Copyright © Егиазарян К.А., Ершов Д.С., Миленин О.Н., Пиманчев О.В., Кондырев Н.М., Бадриев Д.А., Рафиков В.О., 20232023Егиазарян К.А., Ершов Д.С., Миленин О.Н., Пиманчев О.В., Кондырев Н.М., Бадриев Д.А., Рафиков В.О.Egiazaryan K.A., Ershov D.S., Milenin O.N., Pimanchev O.V., Kondyrev N.M., Badriev D.A., Rafikov V.O.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.spractice.ru/jour/article/view/430

Последствия травм плечевого сустава на сегодняшний день являются одной из важнейших проблем в современной травматологии. Различные виды эндопротезирования способны обеспечить восполнение утраченной функции в результате перенесенного перелома или вывиха проксимального отдела плечевой кости. На фоне выраженного дефицита вращающей манжеты плеча (ВМП) у пожилых пациентов и у пациентов со значительно устаревшими повреждениями оправданным выбором служит реверсивное эндопротезирование (РЭ). Развитию этого направления способствовал накопленный опыт повсеместного применения анатомической артропластики плечевого сустава (ПС). Осложнения, прогрессирующая несостоятельность с недолгосрочным результатом привели к поиску решения проблем сложных переломов и вывихов в методе реверсивной артропластики, изобретенном для лечения ротаторной артропатии ПС. Однако широкое применение РЭ далеко не во всех случаях последствий переломов и вывихов показало отличные и хорошие результаты. Осложнения механического характера, в частности перипротезные переломы, широко распространены при РЭ и возникают в 3 раза чаще, чем при анатомической тотальной артропластике плечевого сустава. Актуальность данной проблемы с учетом снижения реабилитационного потенциала пациента на фоне интраоперационных или послеоперационных переломов плечевой кости и лопатки, приводящих к стойкому дефициту функции плечевого сустава, определила необходимость проведения данного исследования.

Complications of shoulder joint traumas stand as a significant concern in modern traumatology. Various forms of endoprosthetics offer the potential to restore lost function resulting from fractures or dislocations of the proximal humerus. In the context of a significant deficiency in the rotator cuff of the shoulder (RC) in elderly patients with notably aged injuries, reverse endoprosthetics (RE) emerges as a justifiable choice. The accrued experience from the widespread adoption of anatomical arthroplasty of the shoulder joint (PS) has significantly influenced the evolution of this approach. Complications and progressive failures with short-term outcomes prompted the quest for solutions to the challenges posed by complex fractures and dislocations through the method of reverse arthroplasty, originally devised for treating rotatory arthropathy of the shoulder. However, the extensive application of RE has not consistently yielded excellent and good results in all cases of post-fracture and dislocation consequences. Mechanical complications, particularly periprosthetic fractures, are prevalent in RE and occur three times more frequently than in anatomical total arthroplasty of the shoulder joint. The urgency of this problem, considering the diminished rehabilitation potential of patients against the backdrop of intraoperative or postoperative fractures of the humerus and scapula, leading to a persistent deficit in the function of the shoulder joint, underscores the necessity of this study.

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The authors declare that there are no conflicts of interest present.