ABSTRACT
The paper deals with the principles of management of combined mechanical injuries to the upper extremities with special reference to amputation of their segments based on the 3-year experience with the treatment of 1488 patients including 405 ones with traumatic amputations. Replantation of large and small segments was undertaken in 24 and 76% of the cases respectively. 43% of the patients underwent one-step traumatic amputation of two and more segments. Skin and soft tissue defects occurred in 111 patients including 27 with extensive lesions. 82.4% of the surgical interventions had the desired outcome. An example of successful replantation is described. The results are compared with the literature data.
Subject(s)
Amputation, Traumatic/surgery , Brachial Artery , Multiple Trauma/surgery , Transportation , Upper Extremity/blood supply , Upper Extremity/injuries , Upper Extremity/surgery , Adolescent , Adult , Amputation, Traumatic/diagnostic imaging , Amputation, Traumatic/etiology , Amputation, Traumatic/physiopathology , Brachial Artery/injuries , Brachial Artery/surgery , Child , Female , Humans , Male , Middle Aged , Multiple Trauma/complications , Multiple Trauma/diagnostic imaging , Multiple Trauma/physiopathology , Necrosis/etiology , Practice Guidelines as Topic , Radiography , Replantation/adverse effects , Replantation/methods , Transportation/methods , Transportation/standards , Treatment Outcome , Upper Extremity/diagnostic imagingABSTRACT
The article deals with one of the currently important problems encountered in modern microsurgery, i. e., a possibility of performing restorative operations in complete and incomplete traumatic amputations of hand fragments. Our experience gained in managing a total of one hundred and fifty-one patients has confirmed the necessity of performing primary reconstructive operations on vessels, which in the majority of cases makes it possible to save the damaged segments. Also given herein are the main indications for carrying out restorative operations, with the appropriate conclusions drawn.
Subject(s)
Amputation, Traumatic/surgery , Finger Injuries/surgery , Fingers/blood supply , Multiple Trauma/surgery , Replantation/methods , Vascular Surgical Procedures/methods , Wrist Injuries/surgery , Adult , Female , Fingers/surgery , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome , Young AdultABSTRACT
The article deals with certain aspects of managing patients presenting with extremital bone-and-vascular injuries known for utter severity and a high incidence rate of postoperative complications. Suggested herein, as the authors believe, is an optimal for both the patient and surgeon policy of emergency reconstruction. Emphasis is placed on the necessity to follow a certain sequence while restoring the anatomical structures destroyed. The conclusions drawn include compulsorily considering a possibility to spare the damaged segment, followed by restoring adequate blood circulation and prevention of wound infection, carrying out osteosynthesis with obligatory shortening of the bones, and postponing orthopaedic measures for the remote postoperative period. Also presented in the article is a photograph-illustrated clinical case report of a successful brachial replantation.
Subject(s)
Amputation, Traumatic/surgery , Hand Injuries/surgery , Humeral Fractures/surgery , Humerus/injuries , Replantation/methods , Amputation, Traumatic/diagnostic imaging , Child , Follow-Up Studies , Fracture Fixation, Intramedullary/methods , Hand Injuries/diagnostic imaging , Humans , Humeral Fractures/diagnostic imaging , Humerus/diagnostic imaging , Humerus/surgery , Male , Radiography , Recovery of Function , Trauma Severity IndicesABSTRACT
Of 61 injured person, to whom the replantation of the extremity's large segment was conducted, the replantated segment revivement was noted in 43 (83%). The acceptable functional rehabilitation of the extremity was achieved in 38 (88.4%) patients due to conduction of various correcting interventions in late postoperative period.
Subject(s)
Amputation, Traumatic/surgery , Replantation/methods , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Microsurgery/methods , Middle Aged , Retrospective StudiesABSTRACT
Experience with the examination and treatment of 162 patients with excretory (79) and secretory (83) forms of male infertility is analysed. With regard for the data of spermography, biopsy of a testicle, the results of surgical treatment of the patients with the use of microvascular technique were evaluated. Microsurgical correction of different forms of male infertility has the best prospects.
