Kirichenko V. Medical rehabilitation of patients with chronic of wrist injuries

Object: wrist joint old lacerations. The aim of research - to develop and prove methodology of medical rehabilitation of patients in cases of a wrist joint old laceration by improvement of reconstructive operations, complex restoration of injured extremity function and definition of functional infringements criteria. Methods of research - clinical, radiological, instrumental, electrophysiological, modeling, biomechanical, statistical. Scientific novelty. For the first time, being based on results of an experimental research of anatomic preparations of intact wrist scaphoid and bone fragments at chronic fractures, stress concentration zones are determined, compression screw design and osteosynthesis technology of scaphoid is improved. Indications to endoprosthesis replacement of a wrist scaphoid are determined. The original model of geometrically similar implant is created on the basis of functional characteristics of the wrist scaphoid and the way of its fixing to adjacent bones of a wrist is developed. The three - level complex of the postoperative differentiated regenerative treatment of patients is developed, depending on the kind and localization of wrist joint damage and reconstructive - regenerative intervention. Dependence of upper extremity functions restoration after reconstructive - regenerative treatment is determined, depending on a kind and prescription of a wrist injury, wrist joint and hand malfunction criteria are determined and objectified. Practical value of the received results. The introduction of a technique of an scaphoid osteosynthesis in practical health protection with the advanced compression screw and the developed technology of scaphoid replacement by geometrically similar implant assisted and also developed methodology of postoperative conduct of patients which includes three periods, has allowed to improve the function of a hand, domestic and professional adaptation of injured person and to increase efficiency of patients rehabilitation. The wrist joint malfunction criteria, which were determined by us, and the use of the sample program of medical rehabilitation of patients and invalids allowed to improve dynamics of disability. Results of researches are introduced in the following works: Sitenko Institute of Spine and Joint Pathology Ukrainian Academy of Medical Sciences, Kharkov; Ukrainian State Institute of Medical and Social Problems of Disability; M.Gorkogo Scientific Research Institute of Traumatology and Orthopedy of Donetsk State Medical University. Materials of the dissertation are introduced into the educational process of medical-social examination faculty ASF of the Dnepropetrovsk state medical academy.