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Surgical treatment of acromioclavicular dislocation


Author: Tulbure Vasile
Degree:doctor of medicine
Speciality: 14.00.22 - Orthopedics and Traumatology
Year:2016
Scientific adviser: Gornea Filip (decedat)
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 30 March, 2016
Approved by NCAA on the 3 June, 2016

Abstract

Adobe PDF document – 0.83 Mb / in romanian

Thesis

CZU 616.717.2-001.6-089

Adobe PDF document 5.77 Mb / in romanian
133 pages

Keywords

acromioclavicular dislocation, biomechanics of shoulder, coraco-clavicular ligament plasty, scapula, clavicle

Summary

Thesis structure. The thesis is exposed on 107 pages of typed text and contains: introduction, 5 chapters, conclusion, practical recommendations, bibliography based on 158 sources.

The thesis is illustrated with 12 tables, 66 diagrams and 9 annexes. The results were published in 8 scientific papers and one patent for inventions.

Domain of the research: The research included 175 patients with types III, IV, V Rockwood and Green acromioclavicular dislocation, including 139 patients wich were treated using usual methods and 36 patients wich were treated using coraco-clavicular ligament plasty with sustainable nonabsorbable fibers.

The aim and objectives of the research. It includes the argumentation and the optimization of the reconstructive contemporary surgical techniques in treatment of acromioclavicular dislocation for improving the anatomical and functional outcomes. It was assessed the frequency of acromioclavicular dislocations depending on age, sex, time of addressing in order to choose the optimal method of surgical treatment and to obtain favorable anatomical and functional results. It was biomechanically determined the physiological strength of the capsulo-ligament apparatus and restored by usual methods and coraco-clavicular ligament plasty with different sustainable nonabsorbable fibers. It were developed and implemented in practice a new method of surgical treatment, a device for reduction and minimally invasive formation of the coraco-clavicular tunnel and it was effectuated the analysis of distance results.

Novelty and scientific originality. Within the biomechanical study was determined the strength of capsulo-ligamentous complex of acromioclavicular joint entirely and differencially of acromio-clavicular ligaments together with the capsule and stabilizing coraco-clavicular ligaments.

The important solved in the reserch scientific problem. It were clinically and experimentally argued the priorities of coraco-clavicular ligament plasty only with sustainable nonabsorbable fibers in two planes according to vectors of trapezoid and conoids ligaments in type III of acromioclavicular dislocation and temporary artrosinthesis in types IV and V Rockwood and Green acromioclavicular dislocations.

The theoretical significance and the application value of the research. The study argued and confirmed the usefulness and priority of surgical treatment methods in acromio-clavicular dislocation using coraco-clavicular ligament plasty in two planes with sustainable nonabsorbable fibers, compared to usual methods.

Implementation of scientific results. The method of surgical treatment of the acromio-clavicular dislocation using coraco-clavicular ligament plasty with different sustainable nonabsorbable fibers is implemented in medical practice in Public Medical Hospital of Traumatology and Orthopedics, Department of Traumatology and Orthopedics of Emergency Medicine Institute.