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Khirurgii

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Year 2016 Vol. 24 No 1

TRAUMATOLOGY & ORTTHOPEDICS

V.P. DEYKALO 1, А.N. TOLSTIK 1, K.B. BOLOBOSHKO 1, А.I. KRYLOV 2, А.N. MASTYKOV 1

MEDICAL REHABILITATION IN HAND INJURIES USING THE METHOD OF FINGERS AND METACARPAL BONES TRANSPOSITION

EE "Vitebsk State Medical University" 1,
ME "Vitebsk Regional Clinical Hospital" 2,
The Republic of Belarus

Objectives. The improved outcomes of patients with various consequences of the open hand injuries were related to the using the method of transposition of fingers and/or metacarpal bones.
Methods. Medical rehabilitation of patients (n=21) had been carried out. All patients were males (15-38 years). Injuries term – 3-12 months ago. The method consisted in transposing the adjacent finger and metacarpal into the defect (n=18) at the pathology of the 3rd and 4th fingers, transposition of the metacarpals of the fingerless hand with simultaneous deepening of spacing between fingers (n=2) was done, in one case with the help of transposition of the 2nd finger the pollicization was performed. The long-term results in different periods (1-25 years) were studied in all patients using the worked out method of determining the degree of functional disorder and disability at hand injuries and diseases.
Results. In all cases in patients with post-traumatic defects of the third or fourth fingers, the function of the hand was significantly improved (25% prior surgery and 90-100% functional restoration – after transposition). The absence of one of the fingers did not cause the patients and the people around them feeling of hand cosmetic defect, and they were satisfied with the the results of operation. Two patients with fingerless hand (100% hand dysfunction) as a result of the transposition performance of the metacarpals with the deepening of interdigital spaces was managed to restore the function of capturing and retaining of large things. After the 2nd finger is transposed to the base of the 1st one (the loss of thumb leads to hand dysfunction to 40%) a hand functional recovery achieved to 75%.
Conclusion. The use of the method of transposition of fingers and/or the metacarpals for the rehabilitation of patients helps significantly to improve the function of the hand and this method is believed to be more efficient for rehabilitation of patients with consequences of severe open hand injuries.

Keywords: consequences of open hand injuries, transposition of fingers and metacarpal bones, the long-term results, disability, posttraumatic defects, significant improvement, medical rehabilitation
p. 70-76 of the original issue
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Address for correspondence:
210023, Republic of Belarus,
Vitebsk, pr-t. Frunze, d. 27,
UO "Vitebskiy gosudarstvennyiy
meditsinskiy universitet",
kafedra travmatologii,
ortopedii i voenno-polevoy khirurgii,
tel. mob. 80296414929.
e-mail: barrett@tut.by,
Deykalo Valeriy Petrovich
Information about the authors:
Deykalo V.P. MD, professor of traumatology, orthopedics and military surgery of EE "Vitebsk State Medical University".
Tolstik A.N. PhD, an associate professor, a head of traumatology, orthopedics and military surgery of EE "Vitebsk State Medical University".
Boloboshko K.B. PhD, an associate professor of traumatology, orthopedics and military surgery of EE "Vitebsk State Medical University".
Krylov A.I. A head of the orthopedics and trauma department of ME "Vitebsk Regional Clinical Hospital".
Mastykov A.N. PhD, an associate professor of traumatology, orthopedics and military surgery of EE "Vitebsk State Medical University".
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