RESUMO
The authors discuss the results of treatment of 56 patients with adduction cicatricial contractures of the thumb which developed after severe mechanical, gunshot and thermal injuries. According to the degree of the deformity, 3 degrees of contractures are distinguished and each cells for certain therapeutic tactics. Various types of free and pedicle dermatoplasty and a method of dosed distraction by means of apparatuses designed in the clinic were employed. Among 40 patients who were examined 35 showed good functional and cosmetic results.
Assuntos
Contratura/cirurgia , Deformidades Adquiridas da Mão/cirurgia , Polegar/lesões , Adulto , Cicatriz/complicações , Cicatriz/cirurgia , Contratura/etiologia , Feminino , Deformidades Adquiridas da Mão/etiologia , Humanos , Masculino , Transplante de Pele/métodos , Retalhos Cirúrgicos , Polegar/anormalidadesAssuntos
Amputação Traumática/etiologia , Traumatismos dos Dedos/etiologia , Utensílios Domésticos , Ferimentos Penetrantes/etiologia , Acidentes Domésticos , Acidentes de Trabalho , Adulto , Amputação Traumática/cirurgia , Feminino , Traumatismos dos Dedos/cirurgia , Humanos , Masculino , Microcirurgia/métodos , Transplante de Pele , Ferimentos Penetrantes/cirurgiaRESUMO
An experience with the treatment of 63 patients with scalped one or several fingers is analyzed. A classification of such traumas is proposed. Plasty with an "acute" Filatow graft, pocket skin plasty, free skin plasty with a splitted transplant were used for completely scalped fingers. In cases with incompletely scalped fingers the decompression of tissues was performed which prevented circulatory alterations. Long-term results within 1-12 years were studied. Indications for each method are analyzed.
Assuntos
Traumatismos dos Dedos/cirurgia , Adulto , Amputação Traumática/patologia , Amputação Traumática/cirurgia , Feminino , Traumatismos dos Dedos/patologia , Seguimentos , Humanos , Masculino , Métodos , Necrose , Ruptura , Pele/patologia , Retalhos CirúrgicosRESUMO
Early necrectomy followed by skin plasty allows preserving impaired parts of the hand and working capacity of the patients in posttraumatic necrosis of soft tissues of the hand and fingers. The method of skin plasty and time of its fulfilling should be dependent on the character of injuries, their localisation and degree of necrosis. In the absence of wound infection skin plasty must be fulfilled immediately after necrectomy. In necrosis accompanied by suppuration skin plasty is indicated after preparing the wound surface with vacuum and ultrasonic treatment, controlled abacterial environment. Positive results of reestablishing working capacity were obtained in 88.6% of the patients examined in remote periods after treatment.
