SU982668A1 - Method of recovery of tendon of deep bender of hand fingers - Google Patents

Description

(54) METHOD OF RESTORING THE TENDONS OF A DEEP BENDER OF PALBERS OF THE HAND

one

The invention relates to medicine, namely to traumatology.

There is a known method for the restoration of the tendons of the deep bend of the fingers of the hand by cutting off one leg of the surface bend, pushing it to the distal end of the deep bend 1.

However, in the implementation, it is known. About the method, adhesions are formed, which block the stitched tendon with the fibrous sheath to the function of the finger is not fully restored. ,

The aim of the invention is to fully restore the range of motion in the interphalangeal joint;

This goal is achieved in that according to the method of restoration of the tendons of the deep flexi of the fingers of the hand by cutting off one leg of the surface flexi bar and stitching it to the distal KOHiJiy deep flexi bar, after prying one leg of the surface flexi bar, tenodiz is produced, then the other leg of the flexion leg is folded and podshchivyut it is removed. deep flexor tendon.

2

The method is carried out as follows.

An arcuate incision of the skin and subcutaneous tissue is made in the palm of the hand, through which the central ends of the superficial and deep flexors are separated. Superficial flexor excised as high as possible. The end of a deep bend is stitched with a thin nylon thread on an atraumatic needle. It then produces a bayonet wound in the area of the main phalanx. Through this access, peripheral segments of the surface flexor are excised from both sides of the middle phalanx. Then, the synovial vagina is incised in the transverse direction in such a way that 5-7 mm of the peripheral segment of the deep flexure is released through the gap formed. After this, with the help of a conductor, the central end of the deep flexor is carried out in the thickness of the subcutaneous tissue in front of the synovial sheath into the wound on the main phalanx of the finger. The central and peripheral ends of the deep bend tendons are stitched with four thin nylon threads on an atraumatic needle. On the central segment of the tendons

deep flexor impose blocking a removable seam on Bunnel. Then, a ring-shaped ligament at the level of the fang bone head is created from the previously excised tendon of the superficial bend. To do this, from the excised area, the tendons of the surface flexion are taken 2-3 mm thick and, with the help of a conductor, are firstly placed under the synovial sheath at the level of the head of the flesh bone, and then annually around the reconstructed tendon of the deep flexionum in the subcutaneous tissue the tendon and the newly created binder had a fiber layer of approximately 0.5 cm. The ends of the binder formed were fastened together with one knotted schw with a thin nylon thread. Then hemostasis is performed and the skin is sewn up with slit sutures. Put back gypsum back of the elbow from the elbow to the tips of the fingers with the arm bent for three weeks. Then the longuet is removed, warm baths, therapeutic exercises, massage, iontophoresis with ronidase, rhythmic galvanization of flexor muscles are performed.

Example. Ill P.A., 17 years old, two hours before admission to the clinic, she cut the main phalanx of the second finger of the right hand with a knife, after which the finger stopped bending. When viewed on the flexion surface at the middle of the main phalanx of the second finger of the right hand of the species, a wound of 0.2-1.5 cm was found, located in the oblique direction. There was no active flexion in the proximal and distal interphalangeal joints. The sensitivity of the finger distal to the injury site is not impaired. Under local infiltration anesthesia, operations were performed according to the proposed method. The stitches were removed on the tenth day. Healing by primary tension. Three weeks later, sn that langetta. Warm baths, medical gymnastics, massage, iontophoresis with ronidase on the postoperative scar area, rhythmic galvanization of flexor muscles were prescribed. The patient was discharged from the clinic for outpatient treatment. Two months after the operation, an active extension to an angle of 180 °, active flexion to an angle of 90 ° was observed in the proximal interphalangeal joint, active extension to an angle of 175 ° in the distal interphalangeal joint, active flexion to an angle of 155 °. Marked almost complete restoration of the function of the finger.

Example 2. Patient K.M.P., 24 years old, an hour before a broken glass jar arrived, cut the main phalanx of the fifth finger of the right hand, as a result of which the finger stopped bending. When viewed on the flexion surface at the middle of the main phalanx of the fifth finger of the right hand there was a wound 0.3x1.5 cm, located in the transverse direction. There was no active flexion in the proximal and distal interphalangeal joints. The sensitivity of the finger distal to the injury site was slightly reduced on the elbow side. The operation according to the proposed method. The postoperative period was uneventful. Spent rehabilitation treatment is the same as in the previous patient (example 1). One month after the operation, active extension to an angle of 165 ° was observed, active flexion to an angle of 120 ° in the proximal interphalangeal joint, in the distal interphalangeal joint, active extension to an angle of 178 °, active flexion to an angle of 160 °. There was the possibility of pinching a finger.

Example 3. Patient P. G. I., 24 years old, was admitted with a diagnosis of damage to the deep and superficial flexor of the U finger

left hand in the main phalanx. From the anamnesis, it was established that three weeks before the admission he cut the main phalanx of the second finger of the left hand with a lid from a tin can. In a rural hospital, stitches were put on the skin. After healing

wounds, finger function not recovered. When viewed on the flexion surface P of the finger of the left hand, an old scar of 0.2X1 cm is seen. Active flexion in the distal and proximal interphalangeal joints

is impossible. Conducted an operation according to the proposed method. The postoperative period was uneventful. Conducted rehabilitation treatment. After a month after the operation, active extension was observed in the proximal inter-falancing

joint up to an angle of 160 °, active flexion to an angle of 125 °, in the distal interphalangeal joint active extension to an angle of 175 °, active flexion to an angle of 165 °. There was the possibility of pinching a finger.

The proposed method has been applied in the treatment of 12 patients, and it has been found that it allows to completely restore the range of motion in the interphalangeal joint, the operation is low-impact and effective.

Claims (1)

Invention Formula The method of restoring the deep flexor tendons of the hand by cutting off one leg of the surface flexion and stitching it to the distal end of the deep flexigel, characterized in that, in order to fully restore the range of motion in the interphalangeal joint, after stitching one leg of the surface fold, the tenolysis is performed, then cut off another leg of the surface bend and hem it to the restored tendon of the deep bend. 5, Sources of information taken into account during the examination 1. Degt roar S. I. Method of stabilization of the nail phalanx with isolated damage to the tendons of the deep flexor fingers of the hand. In the book: “Actual issues of traumatology and orthopedics. Issue 1, M., 1970, p. 17-18.