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 SM ISO690:2012VACARCIUC, Ion. Scorul aprecierii gravităţii leziunilor deschise ale mâinii şi principiile de tratament chirurgical. In: Sănătate Publică, Economie şi Management în Medicină , 2012, nr. 3(42), pp. 89-92. ISSN 1729-8687. |
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| Sănătate Publică, Economie şi Management în Medicină | ||||||
| Numărul 3(42) / 2012 / ISSN 1729-8687 /ISSNe 2587-3873 | ||||||
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| Pag. 89-92 | ||||||
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Morphofunctional hand rehabilitation after open injuries of the hand represents a diffi cult task, especially if they are associated with tendons, skeletal, peripheral nerves or vascular injuries. Our experience for the period 1999-2010 include 116 cases with patients aged between 16 and 65 year, 95 male and 21 female patients. In 82 cases we diagnosted a bone fracture. In 91 cases fl exor tendon injuries were located as it follows: zone l – 4, zone ll – 38, zone lll – 16, zone lV – 7 and zone V – 26. In 19 cases there were extensors injuries. The nerve lesions were associated to hand injuries in 84 cases. Nerve injuries consisted in multiple lesions of the proper digital nerves – 29 cases, lesions of the common digital nerves at palm level – 21 cases, lesions of the median ar ulnar nerves in the forearm – 34 cases, combined injuries of median and ulnar nerves were found in 18 cases. Surgical management included: bone fi xation (K wires) – 73 cases, in 6 cases – plates and bones screws and in 3 cases – Ilizarov fi xation. The tendon’s reconstruction and neurorraphy – in 48 cases, in 3 cases we used a superfi cial tendon for profound tendon and in 15 cases we used Paneva-Holevich method. In 44 cases the nerve reconstruction was also performed, epyperineurorraphy was used in 69 cases, and the epyneurorraphy – in 7 cases, neurorraphy and neurolysis – in 8 cases. The hand injury severity scoring system have been successfully used in our investigation, and minor injuries where – in SCORUL APRECIERII GRAVITĂŢII LEZIUNILOR DESCHISE ALE MÂINII ŞI PRINCIPIILE DE TRATAMENT CHIRURGICAL Ion VACARCIUC Catedra Ortopedie şi Traumatologie, USMF N. Testemiţanu 12 (10,34%) cases, moderate – in 56 (48,27%), major in 32 (27,58%) and severe in 16 (13,79%) cases. The long term follow – up included 67 patients and results sere considered: as excellent in 22 cases (32,8%) as good in 28 cases (41,8%), satisfactory in 12 cases (17,9%) and poor in 5 cases (7,5%). |
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Cerif XML Export
<?xml version='1.0' encoding='utf-8'?> <CERIF xmlns='urn:xmlns:org:eurocris:cerif-1.5-1' xsi:schemaLocation='urn:xmlns:org:eurocris:cerif-1.5-1 http://www.eurocris.org/Uploads/Web%20pages/CERIF-1.5/CERIF_1.5_1.xsd' xmlns:xsi='http://www.w3.org/2001/XMLSchema-instance' release='1.5' date='2012-10-07' sourceDatabase='Output Profile'> <cfResPubl> <cfResPublId>ibn-ResPubl-104004</cfResPublId> <cfResPublDate>2012-05-04</cfResPublDate> <cfVol>42</cfVol> <cfIssue>3</cfIssue> <cfStartPage>89</cfStartPage> <cfISSN>1729-8687</cfISSN> <cfURI>https://ibn.idsi.md/ro/vizualizare_articol/104004</cfURI> <cfTitle cfLangCode='RO' cfTrans='o'>Scorul aprecierii gravităţii leziunilor deschise ale mâinii şi principiile de tratament chirurgical</cfTitle> <cfAbstr cfLangCode='EN' cfTrans='o'><p>Morphofunctional hand rehabilitation after open injuries of the hand represents a diffi cult task, especially if they are associated with tendons, skeletal, peripheral nerves or vascular injuries. Our experience for the period 1999-2010 include 116 cases with patients aged between 16 and 65 year, 95 male and 21 female patients. In 82 cases we diagnosted a bone fracture. In 91 cases fl exor tendon injuries were located as it follows: zone l – 4, zone ll – 38, zone lll – 16, zone lV – 7 and zone V – 26. In 19 cases there were extensors injuries. The nerve lesions were associated to hand injuries in 84 cases. Nerve injuries consisted in multiple lesions of the proper digital nerves – 29 cases, lesions of the common digital nerves at palm level – 21 cases, lesions of the median ar ulnar nerves in the forearm – 34 cases, combined injuries of median and ulnar nerves were found in 18 cases. Surgical management included: bone fi xation (K wires) – 73 cases, in 6 cases – plates and bones screws and in 3 cases – Ilizarov fi xation. The tendon’s reconstruction and neurorraphy – in 48 cases, in 3 cases we used a superfi cial tendon for profound tendon and in 15 cases we used Paneva-Holevich method. In 44 cases the nerve reconstruction was also performed, epyperineurorraphy was used in 69 cases, and the epyneurorraphy – in 7 cases, neurorraphy and neurolysis – in 8 cases. The hand injury severity scoring system have been successfully used in our investigation, and minor injuries where – in SCORUL APRECIERII GRAVITĂŢII LEZIUNILOR DESCHISE ALE MÂINII ŞI PRINCIPIILE DE TRATAMENT CHIRURGICAL Ion VACARCIUC Catedra Ortopedie şi Traumatologie, USMF N. Testemiţanu 12 (10,34%) cases, moderate – in 56 (48,27%), major in 32 (27,58%) and severe in 16 (13,79%) cases. The long term follow – up included 67 patients and results sere considered: as excellent in 22 cases (32,8%) as good in 28 cases (41,8%), satisfactory in 12 cases (17,9%) and poor in 5 cases (7,5%).</p></cfAbstr> <cfAbstr cfLangCode='RU' cfTrans='o'><p>Анатомическая и функциональная реабилитация больных с открытыми травмами кисти до сих пор проблематична, если это сочетанное повреждения: скелета, сухожилья сгибателей, периферических нервов, магистральных сосудов. Наш опыт (1999-2010) основан на лечения 116 больных с открытыми повреждениями кисти, 95 мужского и 21 женского пола. В 82 (70,7%) случаях были выявлены открытые переломы костей. У 91 (78,45%) были повреждения сухожилья сгибателей: в I зоне 4, во II зоне – 38, в III зоне – 16, в IV зоне – 7 и в V зоне – 26 больных. У 19 пострадавших были повреждения разгибателей на различных уровнях. Открытые повреждения кисти у 84 (72,41%) больных были с повреждениями периферических нервов. При переломах костей, остеосинтез спицами произвели у 73 (89,02%) пациентов, остеосинтез пластинкой – у 6 (7,32%) и у 3 (3,66%) – стабилизацию фрагментов аппаратом Илизарова. У 48 (52,74%) произвели первичное сшивание сухожилий сгибателей. Эпипериневральный шов периферических нервов использовали у 76 (90,47%) больных и только у 8 (9,53%) пострадавших с повреждениями пальцевых нервов использовали эпиневральный шов. Для определения тяжести открытых повреждений кисти мы использовали «шкалу открытых повреждений кисти», предложенную Campbell D.A., Kay S.P.J., 1996. По этой шкале: с минимальной травмой были - 12 (10,34%) больных, с травмой средней тяжести – 56 (48,27%), с тяжёлой травмой – 32 (27,58%) и крайне тяжёлые травмы – у 16 (13,79%) пострадавших. Отдалённые результаты изучены у 67 (64,38%) больных по шкале Мичиганского опросника (Michigan Hand Outcomes Questionnare, 1998) и отличные результаты были у 22 (32,8%) больных, хорошие – у 28 (41,8%), удовлетворительные – у 12 (17,9%) и неудовлетворительные – у 5 (7,5%) пациентов.</p></cfAbstr> <cfResPubl_Class> <cfClassId>eda2d9e9-34c5-11e1-b86c-0800200c9a66</cfClassId> <cfClassSchemeId>759af938-34ae-11e1-b86c-0800200c9a66</cfClassSchemeId> <cfStartDate>2012-05-04T24:00:00</cfStartDate> </cfResPubl_Class> <cfResPubl_Class> <cfClassId>e601872f-4b7e-4d88-929f-7df027b226c9</cfClassId> <cfClassSchemeId>40e90e2f-446d-460a-98e5-5dce57550c48</cfClassSchemeId> <cfStartDate>2012-05-04T24:00:00</cfStartDate> </cfResPubl_Class> <cfPers_ResPubl> <cfPersId>ibn-person-12097</cfPersId> <cfClassId>49815870-1cfe-11e1-8bc2-0800200c9a66</cfClassId> <cfClassSchemeId>b7135ad0-1d00-11e1-8bc2-0800200c9a66</cfClassSchemeId> <cfStartDate>2012-05-04T24:00:00</cfStartDate> </cfPers_ResPubl> </cfResPubl> <cfPers> <cfPersId>ibn-Pers-12097</cfPersId> <cfPersName_Pers> <cfPersNameId>ibn-PersName-12097-2</cfPersNameId> <cfClassId>55f90543-d631-42eb-8d47-d8d9266cbb26</cfClassId> <cfClassSchemeId>7375609d-cfa6-45ce-a803-75de69abe21f</cfClassSchemeId> <cfStartDate>2012-05-04T24:00:00</cfStartDate> <cfFamilyNames>Vacarciuc</cfFamilyNames> <cfFirstNames>Ion</cfFirstNames> </cfPersName_Pers> </cfPers> </CERIF>
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