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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">spractice</journal-id><journal-title-group><journal-title xml:lang="ru">Хирургическая практика</journal-title><trans-title-group xml:lang="en"><trans-title>Surgical practice (Russia)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2223-2427</issn><publisher><publisher-name>АНО "Консорциум "Медицинская техника"</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.5922/2223-2427-2024-9-1-5</article-id><article-id custom-type="elpub" pub-id-type="custom">spractice-444</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ ЛИТЕРАТУРЫ</subject></subj-group></article-categories><title-group><article-title>Специфические осложнения, ассоциированные с эндопротезированием плечевого сустава</article-title><trans-title-group xml:lang="en"><trans-title>Specific complications associated with shoulder joint replacement</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6680-9334</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Егиазарян</surname><given-names>К. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Egiazaryan</surname><given-names>K. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Карен Альбертович Егиазарян, доктор медицинских наук, профессор, заведующий кафедрой травматологии, ортопедии и военно-полевой хирургии</p><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>Dr hab. Karen A. Egiazaryan, Professor, Head of the Department of Traumatology, Orthopaedics and Military Field Surgery</p><p>1 Ostrovityanova St, Moscow, 117997</p></bio><email xlink:type="simple">egkar@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7005-2752</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ершов</surname><given-names>Д. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Ershov</surname><given-names>D. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дмитрий Сергеевич Ершов, кандидат медицинских наук, доцент, заведующий учебной частью кафедры травматологии, ортопедии и военно-полевой хирургии</p><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>Dr Dmitry S. Ershov, Education Head of the Department of Traumatology, Orthopaedics and Military Field Surgery</p><p>1 Ostrovityanova St, Moscow, 117997</p></bio><email xlink:type="simple">ershov0808@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6559-4263</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ратьев</surname><given-names>А. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Ratyev</surname><given-names>A. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Андрей Петрович Ратьев, доктор медицинских наук, доцент, профессор кафедры травматологии, ортопедии и военно-полевой хирургии</p><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>Dr hab. Andrey P. Ratiev, Associate Professor, Department of Traumatology, Orthopaedics and Military Field Surgery</p><p>1 Ostrovityanova St, Moscow, 117997</p></bio><email xlink:type="simple">ap@ratiev.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3497-5933</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бадриев</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Badriev</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Денис Айдарович Бадриев, ассистент кафедры травматологии, ортопедии и военно-полевой хирургии</p><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>Denis A. Badriev, Assistant Lecturer, Department of Traumatology, Orthopaedics and Military Field Surgery</p><p>1 Ostrovityanova St, Moscow, 117997</p></bio><email xlink:type="simple">ill1dan@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8002-0260</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кондырев</surname><given-names>Н. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Kondyrev</surname><given-names>N. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Николай Михайлович Кондырев, ассистент кафедры травматологии, ортопедии и военно-полевой хирургии</p><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>Nikolaj M. Kondyrev, Assistant Lecturer, Department of Traumatology, Orthopaedics and Military Field Surgery</p><p>1 Ostrovityanova St, Moscow, 117997</p></bio><email xlink:type="simple">nkondyrev@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0007-0390-3714</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рафиков</surname><given-names>В. О.</given-names></name><name name-style="western" xml:lang="en"><surname>Rafikov</surname><given-names>V. O.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Владимир Олегович Рафиков, лаборант кафедры травматологии, ортопедии и военно-полевой хирургии</p><p>117997, Москва, ул. Островитянова, 1</p></bio><bio xml:lang="en"><p>Vladimir O. Rafikov, Laboratory Assistant, Department of Traumatology, Orthopaedics and Military Field Surgery</p><p>1 Ostrovityanova St, Moscow, 117997</p></bio><email xlink:type="simple">vladimir.raficov@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российский национальный исследовательский&#13;
медицинский университет имени Н. И. Пирогова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pirogov Russian National Research Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>22</day><month>03</month><year>2024</year></pub-date><volume>0</volume><issue>1</issue><fpage>51</fpage><lpage>62</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Егиазарян К.А., Ершов Д.С., Ратьев А.П., Бадриев Д.А., Кондырев Н.М., Рафиков В.О., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Егиазарян К.А., Ершов Д.С., Ратьев А.П., Бадриев Д.А., Кондырев Н.М., Рафиков В.О.</copyright-holder><copyright-holder xml:lang="en">Egiazaryan K.A., Ershov D.S., Ratyev A.P., Badriev D.A., Kondyrev N.M., Rafikov V.O.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.spractice.ru/jour/article/view/444">https://www.spractice.ru/jour/article/view/444</self-uri><abstract><p>Такие осложнения, как повреждение артерий, нервов, дельтовидной мышцы, лопаточный нотчинг, могут перечеркнуть все плюсы эндопротезирования плечевого сустава и привести к крайне плохому функциональному исходу. В случае реверсивного протезирования конструктивная медиализация и дистализация плечевого компонента вызывают тракционную деформацию плечевого сплетения и подмышечных сосудов. В случае отсроченной операции после перелома кровотечение может быть связано с повреждением стенки подмышечной артерии во время релиза спаянных и рубцово-измененных мягких тканей. Неврологические осложнения после реверсивного эндопротезирования (РЭ), как правило, являются обратимыми, но некоторые из них не купируются, что приводит к стойкому неврологическому дефициту. Наиболее критичным является повреждение подмышечного нерва. Причин для этого много: использование острых ретракторов типа Хомана, релиз гленоидальной впадины, тракция плечевой кости во время операции и дальнейшая ее дистализация. Фиксация лопаточного компонента винтами может привести к повреждению надлопаточного нерва. Серьезным осложнением, приводящим к плохому результату РЭ, остается дисфункция дельтовидной мышцы вследствие повреждения подмышечного нерва или разрывов мышечных волокон. Нотчинг-синдром связан с механическим соударением плечевого компонента эндопротеза с лопаточной костью. Вывих плечевого компонента не является редким осложнением и одним из предрасполагающих факторов становится отсутствие достаточного натяжения мягких тканей из-за неправильного положения имплантата.Актуальность последствий данных осложнений, широкое разнообразие причин, относительная «редкость» реверсивного эндопротезирования, предшествующая травма с изменением анатомии плечевой области, крайне плохие функциональные исходы, различные подходы к решению проблем и определили необходимость проведения данного исследования.</p></abstract><trans-abstract xml:lang="en"><p>Complications such as scapular notching or artery, nerve and deltoid muscle damage can outweigh the benefits of shoulder joint replacement and result in poor functional outcomes. Reverse shoulder joint replacement may cause traction deformation of the brachial plexus and axillary vessels due to constructive medialistion and distalisation of the shoulder component. Delayed surgery after a fracture can lead to bleeding from damage to the axillary artery wall during the release of scarred soft tissues. Although most neurological complications after reverse arthroplasty (RA) are reversible, some persist, particularly damage to the axillary nerve. These complications can occur due to various reasons such as the use of acute retractors, glenoidal cavity release and humerus traction with further distalisation. Fixing the scapular component with screws can damage the supra-scapular nerve. Deltoid muscle dysfunction remains a serious complication due to axillary nerve damage or muscle fibre ruptures. Notching syndrome occurs when the shoulder component of the endoprosthesis collides with the scapula. Shoulder component dislocation, often caused by insufficient soft tissue tension due to implant misplacement, is not uncommon.This study was necessitated by the significance of these complications, their varied causes, the relative rarity of reverse arthroplasty, previous shoulder trauma altering anatomy, poor functional outcomes, and diverse problem-solving approaches.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>артропластика плечевого сустава</kwd><kwd>осложнения эндопротезирования плечевого сустава</kwd><kwd>нестабильность и вывихи компонентов эндопротеза плечевого сустава</kwd><kwd>повреждение дельтовидной мышцы</kwd><kwd>нотчинг-синдром</kwd></kwd-group><kwd-group xml:lang="en"><kwd>shoulder joint arthroplasty</kwd><kwd>complications of shoulder arthroplasty</kwd><kwd>instability and dislocations of shoulder joint endoprosthesis components</kwd><kwd>deltoid muscle damage</kwd><kwd>notching syndrome</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Егиазарян К. 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