RESUMO
5 patients have been implanted the endoprostheses of Sivash K. M. to restore functions of the upper limb after the gunshot injury in the area of elbow joint with the clinico-roentgenologic bone defect detection. Coarse cicatricial changes in the area of an articulation with presence of foreign bodies are characteristic for those patients. There have been achieved significant improvement of restoration of active movement of elbow joint and upper limb in whole with 4 of them in spite of high danger of possible post-operative inflammation. In one case due to hard physical labour there have been noted break of an endoprosthesis with the subsequent inflammation. The endoprosthesis has been removed. The most stable positive outcomes proved by physiological tests of the neuromuscular system of upper limbs are observed at endoprosthetics of elbow joint with replacement of the soft tissue defect with completely vascularized musculocutaneous autotransplant.
Assuntos
Cicatriz/cirurgia , Lesões no Cotovelo , Artropatias/cirurgia , Prótese Articular , Transtornos dos Movimentos/cirurgia , Ferimentos por Arma de Fogo/complicações , Adolescente , Adulto , Cicatriz/etiologia , Articulação do Cotovelo/cirurgia , Feminino , Humanos , Artropatias/etiologia , Transtornos dos Movimentos/etiologia , Músculos/transplante , Transplante de Pele , Retalhos CirúrgicosAssuntos
Fixação de Fratura/métodos , Fraturas do Úmero/cirurgia , Adulto , Idoso , Moldes Cirúrgicos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Squeezed syndrome affecting various segments of limbs has been identified in 245 of 500 victims randomized for examination 6 months after the earthquake. In 119 cases associated with closed fractures of long tubular bones and in 59 cases with open ones. In 124 cases duration of squeezing was up to 12 h, and in 70 cases--1 day and more. Segmental limb amputation was performed in 113 cases. In 95 cases limbs functions were retained and in 81--lost. Perspectives of more successful outcomes depend on the maximal shortening of rescue period, on rational organization of the treatment process and prolongation of recovery management of squeezed syndrome sequelae.
Assuntos
Traumatismos do Braço/terapia , Síndrome de Esmagamento/terapia , Desastres , Traumatismos da Perna/terapia , Choque Traumático/terapia , Traumatismos do Braço/epidemiologia , Armênia , Síndrome de Esmagamento/epidemiologia , Emergências , Seguimentos , Fraturas Fechadas/epidemiologia , Fraturas Fechadas/terapia , Fraturas Expostas/epidemiologia , Fraturas Expostas/terapia , Humanos , Traumatismos da Perna/epidemiologia , Fatores de TempoRESUMO
An analysis of results of using conduction anesthesia for various operations on extremities of 274 patients of different age groups has been made. Complete effects were achieved in 91% of the patients, 5% of the patients were potentiated with neuroleptanalgesia drugs because of insufficient anesthesia, in 2% of the patients general anesthesia was used. The method of conduction anesthesia makes it possible to use a conveyer method of bringing patients to the operating room. It is more economical as compared with narcosis, easy in use. It may be recommended for wider use.
Assuntos
Traumatismos do Braço/cirurgia , Braço/inervação , Traumatismos da Perna/cirurgia , Perna (Membro)/inervação , Bloqueio Nervoso , Adjuvantes Anestésicos/administração & dosagem , Humanos , Lidocaína/administração & dosagem , Medicação Pré-AnestésicaRESUMO
A technique of rehabilitation treatment was suggested and tested on 25 patients with an elbow joint endoprosthesis. The postoperative rehabilitation involved three periods: absolute immobilization, relative immobilization and postimmobilization. Therapeutic measures should be adjusted to each specific stage and imply different physiotherapeutic modalities according to clinical features and duration of the postoperative period: position treatment; passive, light active dynamic exercise, isometric training, underwater exercise; electrostimulation; manual and mechanical massage; occupational therapy. Positive response after adequate postoperative rehabilitation was registered in 20 patients.
Assuntos
Lesões no Cotovelo , Articulação do Cotovelo , Prótese Articular/reabilitação , Adulto , Articulação do Cotovelo/cirurgia , Terapia por Exercício/métodos , Seguimentos , Fraturas Ósseas/reabilitação , Humanos , Pessoa de Meia-Idade , Osteomielite/reabilitação , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Ferimentos por Arma de Fogo/reabilitaçãoRESUMO
A new method of restoration of the function of the upper limb in extensive posttraumatic defects of bones and soft tissues of the cubital joint has been elaborated. The method is based on the excision of scar tissues with simultaneous implantation of the endoprosthesis of the K. M. Sivash type. The produced defect is covered by a free vascularized thoracodorsal skin-muscle transplant using the microstructural technique. Four operations have been performed so far. Clinical observations are reported. The method is efficient as it ensures reliable covering of the hinge part of the endoprosthesis by full-thickness skin, shortening the time of rehabilitation treatment 3-4 times and achieving more complete restoration of the function of the upper limb.
