Year 2016 Vol. 24 No 1




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
  1. Rosberg HE, Steen Carlsson K, Cederlund IR, Ramel E, Dahlin LB. Costs and outcome for serious hand and arm injuries during the first year after trauma – a prospective study. BMC Public Health. 2013;13:501. doi: 10.1186/1471-2458-13-501.
  2. Gupta A, Gupta AK, Uppal SK, Mittal RK, Garg R, Aggarwal N. Demographic profile of hand injuries in an industrial town of north India: a review of 436 patients. Indian J Surg. 2013 Dec;75(6):454-61. doi: 10.1007/s12262-012-0536-2.
  3. Parin BV. Rekonstruktsiia pal'tsev ruki [Reconstruction of the hand fingers]. Moscow, RF: Medgiz; 1944. 135 p.
  4. Azolov VV, Aleksandrov NM. Effektivnost' rekonstruktsii pal'tsev kisti pri posledstviiakh travm razlichnoi etiologii [The effectiveness of the reconstruction of the fingers in the consequences of injuries of different etiologies]. Vestn Travmatologii i Ortopedii im NN Priorova. 2004;(2):82-88.
  5. Azolov VV, Petrov SV, Aleksandrov NM. Rekonstruktivno-vosstanovitel'nye operatsii pri otsutstvii pal'tsev kisti [Reconstructive surgery in the absence of hand fingers]. Ortopediia Travmatologiia i Protezirovanie. 1993;(3):18-25.
  6. Grishin IG, Azolov VV, Vodianov NM. Lechenie povrezhdenii kisti na etapakh meditsinskoi evakuatsii [Treatment of hand injuries during medical evacuation]. Moscow, USSR: Meditsina; 1985. 188 p.
  7. Belousov AE, Tkachenko SS. Mikrokhirurgiia v travmatologii [Microsurgery in traumatology]. Leningrad, USSR: Meditsina; 1988. 224 p.
  8. Barbato BD, Leblan P, Lemerle JP. Thumb reconstruction by pollizisation of the trapeziometacarpal joint. A retrospective comparative study. J Hand Surg. 1998; 23B(1):69-71.
  9. Hoang NT, Staudenmaier R, Hoehnke C. Case reports: Thumb reconstruction using amputated fingers. Clin Orthop Relat Res. 2008 Aug; 466(8):1996–2001. doi: 10.1007/s11999-008-0227-2.
  10. Koriukov AA. Vozmozhnosti sovremennykh metodov reabilitatsii bol'nykh s defektami kisti [The possibilities of modern methods of rehabilitation of patients with defects of the hand]. Ortopediia Travmatologiia i Protezirovanie. 1993;(3):25-32.
  11. Malahias M, Jordan DJ, Hindocha S, Khan W, Juma A. The development and future of reconstructive and microvascular surgery of the hand. Open Orthop J. 2014 Oct 31;8:415-22. doi: 10.2174/1874325001408010415.
  12. Alphonsus CK. Principles in the management of a mangled hand. Indian J Plast Surg. 2011 May-Aug; 44(2):219–226. doi: 10.4103/0970-0358.85343.
  13. Fang F, Chung KC. An evolutionary perspective on the history of flap reconstruction in the upper extremity. Hand Clin. 2014 May;30(2):109-22, v. doi: 10.1016/j.hcl.2013.12.001.
  14. Sabapathy SR, Satbhai NG. Microsurgery in the urgent and emergent management of the hand. Curr Rev Musculoskelet Med. 2014 Mar;7(1):40-46. doi: 10.1007/s12178-013-9197-4.
  15. Deikalo VP, Tolstik AN. Sposob opredeleniia stepeni narusheniia funktsii i poteri trudosposobnosti pri povrezhdeniiakh i zabolevaniiakh kisti [A method of determining the degree of dysfunction and disability in injuries and diseases of the hand]: instruktsiia. Vitebsk, RB; 2006. 20 p.
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.
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".
Contacts | ©Vitebsk State Medical University, 2007-2023