Domanskij A. Surgical treatment of patients with consequences multistructural forearm and hand injures

This work is dedicated to the problems of surgical treatment of patients with consequences multistructural forearm and hand injuries. In the conditions of the experiment a morphological estimation of the influence of neurorrhaphy with miovascularization on the regeneration of peripheral nerve was made. We have determinated that miovascularization reduces formation of scar tissue in the seam area of peripheral nerves and decreases the proportion of collagen component in regenerative neuroma. On the basis of immunohistochemical study the methodology for treatment of posttraumatic compression-ischemic neuropathy was improved. The defined indications for reconstructive and restorative treatment of the consequences of damaged nerves and tendons, bones and soft tissue structures, contractures of radiocarpal joint and fingers. Analysing the results of reconstructive-restorative treatment 96 patients of clinical groups with the consequences of multistructural forearm and hand injuries. We saw a positive dynamics in the immediate and remote periods after treatment in all clinical groups. Excellent results were obtained in 3 (3.1%) patients, good - in 34 (35,4%), satisfactory - in 41 (42,7%), unsatisfactory - in 18 (18,8%). The use of original methods allowed to obtain excellent and good outcomes in 65% (in 13 of 20 patients) of cases.