UTILIZATION OF DAMAGED SEGMENTS IN RESTORATION OF INJURED HAND FUNCTION

Aim. To improve functional abilities of the posttraumatic hand stump after reconstructive surgeries using the damaged tissue segments. Materials and methods. Experience of treatment of 58 patients with different posttraumatic hand stumps was summarized. To restore grasp function, the damaged tissue resources of the injured hand were used; new techniques for surgical treatment based on the principles of performing local-plastic surgeries were offered. The character of reconstruction corresponded to the form of the posttraumatic defect of the hand and included transplantation or displacement of finger fragments and metacarpal bones as well as their distraction lengthening. In addition to clinical, there were applied radial, biomechanical, electrophysiological and statistical methods of investigation. Results. In all cases, reconstructive operations using the preserved and damaged tissues resulted in improvement of functional abilities of hand stumps. In most observations (80 %), bilateral grasp of injured hand was restored, in the rest patients - flat and hamate grasps. Conclusions. Damaged tissues and segments of the injured hand used in local-plastic surgeries permit to significantly improve its functional abilities and to restore important types of grasps.

Posttraumatic defects, hand stumps, surgical treatment