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SM ISO690:2012 VACARCIUC, 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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