Correction deformity and restoration of hand function when the consequences of deep burns through the use of distraction transosseous devices

Prof., MD, PhD     Sergey Yakovlev

City Clinical Hospital № 6, the Regional Burn Center;
Mailing address of the index: str. Rumyantsev, City Clinical Hospital № 6, Chelyabinsk, Russia, 454047; Phone +7-( 351) -721-27-82 (Burn Center) .

Introduction

Damage to the brush with burns seen in more than 40% of cases. The resulting strains require complex reconstructive and restorative treatment. The use of transosseous distraction apparatus allows to solve several important problems simultaneously and in some cases, fully restore the function of the brush.

Materials and Methods

From 2010 to 2015 we have treated 209 patients (298 hands, 472 fingers) with post-burn deformity brush, of which 89 had bilateral damage. Age of patients ranged from 3 to 69 years. In 77 patients (82 hands, 133 fingers) used in the treatment of transosseous distraction apparatus. All patients had severe contracture of the finger joints of mixed origin. Treatment was carried out by an original method using the apparatus of his own design. Evaluation of treatment results was carried out scales DASH, SF-36 and a computer program “Express-examination of patients with pathology of the brush”.

Results

Method allow perform dosage vector distraction, eliminating the strain brush and joint contractures of fingers. Simultaneously, the method allows to perform the required operation on the skin to replace the scar on the areas of healthy skin, as well as to create conditions for the subsequent stages of treatment (recovery of ligaments, tendons, replacement joints). Positive results were achieved in 90.19%. The average recovery period decreased hand function to 18.9 days. All patients had improved function and quality of life self. Number of readmissions decreased from 18.6% to 9.3%. An increase in traffic volume in the joints of the fingers 30 – 60% of the time before treatment. The effect of treatment observed as in the isolated use of apparatus, as well as in combination with the operations on the skin, tendons and joints.

Conclusions

The use of transosseous distraction apparatus at the stages of reconstructive-restorative treatment of post-burn brush deformation and contractures of the finger joints is very effective (and in some cases the only possible and reasonable method of treatment).

Key Words

Burns, treatment, brush, transosseous devices, correction deformity, restoration of hand function.

Biography

Prof. Sergey Yakovlev works 14 years in Chelyabinsk Center thermal injury, a medical practitioner, and is engaged in scientific activities. Sphere of interest activities aimed at restoring the function of the hands of patients. Cured over 2000 patients with burns and wounds, including deep damaging not only the skin but also tendons, muscles and bones. During the work performed over 1500 operations: skin grafts on the wound (including a very sophisticated), transplantation of tendons, prosthetic arthroplasty, as well as many others.

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