RU2160073C1 - Method for treating finger articulation surfaces defects - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves skeletting defective portions of phalanx, resecting phalanx ends and connecting them by means of silicon cylindrical cap having internal convex-concave partition which thickness is determined by defect surface size. Immobilization is carried out with following movements training. EFFECT: accelerated treatment course; reduced risk of traumatic complications. 3 dwg

Description

 The invention relates to medicine, in particular to traumatology, and is intended for the treatment of the effects of injuries of fingers.

 Known methods of treating defects of the phalanges of the fingers by replacing the defective sections of the phalanges that form the joint with endoprostheses [1].

 The methods consist in reserving the ends of the defective phalanges and replacing them with mechanical devices that perform the functions of the joint.

 Known methods contribute to the partial restoration of the range of motion in the joints of the fingers after their damage. However, a disadvantage of the known methods is that when in the finger, the prostheses are enveloped by scar tissue, which also grows in the gaps existing at the attachment points of the individual parts of the mechanical prosthesis. At the same time, prostheses lose their mobility and treatment becomes ineffective.

 The closest, in essence, to the proposed, is a method of treating defects in the articular surfaces of the fingers [2], which we adopted as a prototype.

 The known method consists in skeletonizing defective sections of the phalanges, resecting the defective surfaces, drilling the channels in the phalanges, inserting the legs of an endoprosthesis made of elastic material as a whole, without components into them, and after two weeks restorative treatment is started.

 Thus, the known method is characterized by morbidity and duration and, in addition, insufficiently high efficiency.

 The aim of the proposed method is to reduce the morbidity, while increasing the effectiveness of treatment.

 This goal is achieved by the fact that in the method of treating defects of the articular surfaces of the fingers, including skeletonization of defective phalanx sections, resection of the ends of the phalanges, joining the phalanges with a device performing the function of the joint, immobilization with subsequent development of movements, a silicone cylindrical device is used as the device performing the function of the joint a cap with an internal convex-concave partition, the thickness of which corresponds to the size of the defect to be repaired.

 The essence of the proposed method lies in the fact that after preliminary preparation of the defective surfaces of the proximal and distal phalanges, they put on a silicone cap with an internal convex-concave septum, with its concave surface the seam facing the proximal phalanx, and the convex to the distal one. The thickness of the partition corresponds to the value of the defective surface.

 The ends of the proximal and distal phalanges inserted into the cap are fixed for the time necessary to form a capsule around the device, which allows the device to be firmly fixed at the place of replacement of the former defect.

 This goal is achieved, since the method is characterized by low morbidity and high efficiency.

 The invasiveness of the method is reduced in comparison with the known one, since there is no operation to drill the channel inside the bones of the phalanges forming the joint, which is necessary in the known methods for securing the endoprosthesis.

 The effectiveness of the treatment according to the proposed method increases, since an increase in the range of motion in the joint subjected to treatment is achieved due to the fact that in the silicone cap there are no parts that reduce the angle of flexion in the metacarpophalangeal joint.

 The design of the cap does not prevent the flexors from fulfilling their natural function, since the wall thickness of the cap is minimal and is determined by the strength characteristics of the material.

 The possibility of separation of the phalanges by a silicone gasket, carried out in the proposed method, in the future eliminates the possibility of ankylosis, which increases the effectiveness of the treatment.

 The proposed method is illustrated by the following images.

The figure 1 shows a healthy joint;
figure 2 shows a defect of the phalanx, on which there is no joint;
the figure 3 shows the junction of the defective phalanges after treatment, where:
1 - distal phalanx;
2 - proximal phalanx;
3 - joint;
4 - silicone cap;
5 - internal convex-concave partition.

 An example of a specific implementation.

 Patient V. received damage to his right hand while working on a milling machine. He was admitted to the clinic 2 months after the injury with the diagnosis: "Deformation of 2-5 fingers of the right hand, defect of the articular surfaces of the metacarpophalangeal joints of 2-5 fingers." The operation was performed: excision of the scar of the rear of the hand, refreshing the ends of the phalanges and replacing the defect of the articular surfaces with 2-5 fingers with silicone caps with different thicknesses of the internal convex-concave septum from 8 to 13 mm, depending on the size of the defect. Fixation was carried out using knitting needles for 3 weeks. Plastic surgery of the skin was performed by a rotated radiation graft. After removing the knitting needles after 3 weeks, the patient started rehabilitation treatment on an outpatient basis.

 After 2 months, the function of the fingers is good, the length is preserved, the strength of the hand is satisfactory, there were no complications.

Sources of information
1. Oddwar Aiken, Carlon-Gyeren Hagert. Finger joint replantation. Sat "Recent advances in plastic surgery." M., Medicine, 1985, p. 130.

 2. Korotkova N. L. Surgical rehabilitation of patients with post-traumatic deformities of the joints of the fingers. Abstract of dissertation. N. Novgorod, 1992, p. 16 (prototype).

Claims (1)

 A method for treating defects in the articular surfaces of fingers of a hand, including skeletonization of defective phalanges, resection of the ends of the phalanges, joining the phalanges with a device performing the functions of the joint, immobilization with subsequent development of movements, characterized in that a silicone cylindrical cap with an internal convex-concave partition, the thickness of which is determined by the value of the defective surface.

Images