PRIMARY PLASTIC OPERATIONS FOR OPEN HAND AND FINGERS INJURIES DIRECTED TO RESTORATION OF GRASP FUNCTION

Aim. To study different surgical techniques and aids for primary surgical treatment of patients with traumatic hand and fingers defects so as to determine the most effective ones in restoration of anatomic structures of the hand and its grasp function. Materials and methods. Analysis of surgical treatment of 283 patients with open injuries of the hand and fingers and 417 operations was carried out. Primary surgical treatment was performed at early terms: 275 sufferers – during the first 6-12 hours, 18 persons with later admission had delayed surgery. Ultrasonic treatment of wounds and magneto-laser exposure was used to prepare the wounds for skin-and skin-bone grafting. Hyperbaric oxygenation was applied in the early postoperative period. Results. In connection with peculiarities of surgical treatment of patients with open hand and fingers injuries clinical observations were divided into three groups: primary restorative surgeries of the first finger, primary restorative surgeries in case of ulnar fingers defects and primary restorative surgeries in severe hand injuries. Analysis of direct results of treatment of 283 patients with severe hand and fingers injuries showed that 242 (87%) patients had primary tension wound healing with full graft and transplant taking. Outcomes of treatment were followed up in 176 sufferers (62%). Positive results were reached in 153 (87%) patients, unsatisfactory – in 23 (13%). Conclusion. The principal peculiar feature of primary surgical treatment in case of severe extensive injuries of the hand and fingers is its primary reconstructive character with rational use of a complex of plastic surgery facilities providing restoration of the basic function of the hand – its grasp function.

Hand injury, skin-bone grafting, surgery