Mamet'yev A. A surgical treatment of patients with traumas consequences of a hand's fingers

This work is devoted to questions of surgical treatment of patients with consequences of injuries of the hand's fingers - in the remote terms after a trauma. In conditions of mechanical and mathematical experiments, biomechanical characteristics of a metacarpo-phalangeal joint are determined at a various types of deformation and the maximal loading is established at which the stability of a joint is kept. On the basis results of an experimental research the construction of an endoprothesys of a metacarpo-phalangeal joint is developed and the endoprothesys technology is proposed. Indications for mobilizing operative interventions at deformations of bones and joints of a hand's fingers and terms of carrying out an early functional loading are determined. It is offered the algoritm of a postoperative regenerative treatment in the basis of which the principle of an early functional loading on the adjacent and injured beams of a hand has been put. Thus terms of the beginning and the stages of carrying out were in dependence on the character of a reconstructively-regenerative intervention. The results of analysis which were made in clinical groups (of 108 patients) showed positive dynamics in the nearest and remote periods after the treatment. Effective carrying out of operative interventions and postoperative regenerative treatment have provided conditions for reception of positive results in 92 (95,8 %) cases, at the same time good results have been achieved at 61 (63,6 %) cases, satisfactory results - at 31 (32,2 %) the patient.