shoulder synovectomy

Surgical treatment of shoulder joint rheumatoid arthritis for shoulder joint synovectomy. Rheumatoid arthritis of the ankle joint, protective muscle spasm can cause adduction and internal rotation deformity. The lesion invades the acromion sac, which can lead to rheumatoid bursitis. The completion of the scapular thoracic activity depends on the stability and control of the ankle joint muscles on the ankle joint, and at the same time, the tension of the bursa can be increased. For example, the scapula sac has an inflammatory reaction, and the pain can significantly restrict the scapular thoracic activity. Although hormonal injection in the bursa can relieve pain, it can not be repeated. For this reason, ankle synovium and acromioscopic sac resection are proposed. To relieve the pain, Smith-Peterson et al. proposed acromioplasty, but the procedure did not improve the ankle joint mobility. Because the shoulder joint is a non-weight-bearing joint, satisfactory results can be obtained for semi-articular replacement, total joint replacement, and arthrodesis in advanced lesions. Arthrodesis surgery is indicated for patients with single limb involvement and who do not have indications for arthroplasty. Rylka, Raunio, and Vainio reported severe rotator cuff tears, severe pain, and satisfactory joint fusion. Treatment of diseases: inflammation around the shoulders Incision Use an inverted L-shaped cut in front (Fig. 3.14.1.5.1-3). The upper end of the incision is from a transverse finger below the shoulder joint, parallel to the clavicle direction to the condyle, and then along the deltoid pectoralis major intervertebral space to the middle of the upper arm, ending at the level of the lower edge of the armpit. 2. Exposing the joint capsule The shallow and deep fascia were cut along the direction of the incision. The cephalic vein, the deltoid muscle, and the pectoralis major muscle were found in the distal part of the incision. After the cephalic vein was freed, the pectoralis major muscle was retracted toward the midline. The starting point of the anterior portion of the deltoid muscle on the clavicle was cut, and muscle adhesion of about 1 cm was retained for suturing. The anterior portion of the deltoid muscle and the skin were simultaneously turned outwardly and retracted, revealing the transverse ligament, the biceps femoris head, the subscapularis tendon and the anterior circumflex artery, and the anterior circumflex artery was cut and ligated. The humerus was externally rotated, the scapularis tendon was tightened, and the tendon was cut longitudinally at a distance of 1 cm from the nodule, revealing the anterior side of the ankle joint capsule. 3. Cut the switch capsule Cut the switch capsule and synovial tissue to reveal the leading edge of the inner surface of the synovial membrane, the humeral head and the scapula. In order to facilitate the removal of the humeral head, the incision of the sacral sleeve and the joint capsule can be appropriately extended upward and downward, and then the humerus can be externally rotated and adducted to release the humeral head. Because the synovial tissue around the biceps tendon is often involved, the transverse ligament and long-headed tendon can be cut along the biceps sulcus to reveal the synovial tissue of the long-headed owl and its surroundings. . 4. Cut off the synovium Use a knife or curved scissors to cut off the synovial membrane in front of the joint, remove the humeral head, and use a spoon, rongeur or curved scissors to remove or scrape the synovial membrane behind the joint. Scrape the granulation tissue around the humeral head and shoulder blades, vasospasm, and the necrotic floating cartilage surface. After the synovial tissue in the joint is removed, the synovial tissue in the long head tendon sheath of the biceps muscle is removed. If the long-headed eyelash has been destroyed by erosion, the damaged tendon tissue can be removed, and the distal end of the tendon can be transplanted into the newly-built bone hole in the sulcus. 5. Suture incision After the incision was rinsed with isotonic saline, the humeral head was repositioned, and 1 ml of methyl acetate peptone was partially injected. The incision joint capsule, the subscapularis tendon and the deltoid muscle were sutured, and the incision was layered and sutured.