Опыт реабилитации пациента с тяжелой травмой кисти (клинический случай)

Abstract

Reconstruction of flexor tendons anatomic continuity at the level of osteofibrous canals is one of the most challenging in hand surgery. Due to the complex anatomy of the hand and a high risk of developing postoperative adhesions choosing the optimal treatment protocol remains crucial during flexor tendons rehabilitation period. Surgeons and rehabilitation specialists agree that a number of poor results of flexor tendon surgery can be caused by a wrong postoperative treatment, violation of treatment protocols or just by the lack of adequate rehabilitation measures. The aim of this study is analysis and the description of the case history of treating the teenager with concomitant hand injury after staged reconstructive and restorative nerve and tendon surgery. Materials and methods. The study analyses the use of intratissual electric stimulation (ITES) combined with the complex of special exercises for recovery of upper extremity function at the outpatient rehabilitation stage in patients who underwent nerve and tendon surgery. The objective pain syndrome and trophic innervation of the injured extremity assessment was performed by measuring skin surface electric potential using Gerasimov’s method. The results were interpreted according to “Personalized system of assessing the results of treating trauma and orthopedic patients”. Results. “Combination treatment in the rehabilitation of the upper extremity” proved to be effective to fight pain syndrome and trophic dysfunction of the nervous system. It allows the patient to do the complex of special exercises to prevent limb contracture if used during the late rehabilitation period. It is an efficient method of preventing and treating neurotrophic dysfunctions. Conclusion. The pathogenetically substantiated method of treating upper extremity, the use of intratissual electric stimulation at the outpatient rehabilitation stage of humerus fractures prove to be effective.