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Type of “gloves” – tractional damage of fingers
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Veröffentlicht: | 6. Februar 2020 |
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Objectives/Interrogation: The choice of tactics of surgical treatment for traction finger damage by the type of "gloves".
Methods: From January 2014 to January 2018 we treated 29 patients with a tractional damage of fingers. Of these, 13 were men, and women 16. For the distribution of damage, we used the classification by J. R. Urbaniak, in the modification R. Adani (1996).
Group I patients received only conservative treatment with timely provision of specialized care. Anti-inflammatory treatment was used, including corticosteroid preparations, microcirculatory drugs, anticoagulants, painkillers, physiotherapy and immobilization.
Patients of group II were subjected to surgery aimed at normalizing blood circulation, with extensive defects we used "Filatov flap". Damaged vessels were recovered under x8 fold increase. Binucular magnifiers, microsurgical instruments and microsurgical material 9 / 0-10 / 0 was used.
7 (35%) patients of this group recovered the patency of one vein, 3 (15%) - two veins, 4 (20%) - one artery, 6 (30%) - one artery and one vein.
In group of II patients dominated venous insufficiency: 66.6% (6 patients), in 3 patients (33.3%) the arterial. When manifestations of venous insufficiency, medical leeches were also used.
Results and Conclusions: In the postoperative period, the dynamics were controlled clinically. Of the 29 examined at 21 (72.4%) was evaluated as a good result, these patients were operated during early after trauma (within 3-4 hours from the time the injury). In 8 (27.5%) cases, the result was assessed as unfavorable and this operation was performed for this group of patients to remove the defect of the fingers' covering tissues with the "Filatov flap".
Traction finger injury of the type "gloves" should be considered as a specific traumatic injury that requires immediate medical care in specialized units.