MD256Y

MD256Y - Method of plasty of deep flexor muscle tendon of finger

Info

Publication number: MD256Y
Application number: MDS20090226A
Authority: MD
Inventors: Ion Vacarciuc; Filip GORNEA; Pavel Tapu
Original assignee: Ion Vacarciuc
Priority date: 2009-12-09
Filing date: 2009-12-09
Publication date: 2010-08-31
Also published as: MD256Z

Abstract

Inventia se refera la medicina, in special la traumatologie si ortopedie, si poate fi utilizata pentru tratamentul bolnavilor cu leziuni ale tendonului muschiului flexor al degetelor mainii. Conform inventiei, metoda de plastie a tendonului muschiului flexor profund al degetului mainii consta in aceea ca se efectueaza o incizie pe plica palmara, se mobilizeaza capatul proximal al segmentului distal al tendonului muschiului flexor profund al degetului mainii, apoi se efectueaza o incizie oblica pe suprafata palmara a falangei distale, dupa care se inlatura portiunea restanta a tendonului muschiului flexor profund al degetului mainii impreuna cu tesuturile cicatriceale lasand 5...8 mm de la locul fixarii tendonului muschiului flexor profund al degetului mainii, se introduce un tub de silicon in locul portiunii de tendon inlaturat, dupa care plaga se sutureaza. Peste 5...8 saptamani tubul de silicon se inlatura si in canalul osteofibros restabilit se implanteaza o grefa formata din tendonul muschiului flexor superficial sau din tendonul muschiului flexor palmar lung. Pe partea palmara, in falanga distala, prin locul fixarii tendonului muschiului flexor profund se introduce o brosa sub un unghi de 55...65°, deschis distal, cu exteriorizarea capatului distal, care apoi se indoaie si de acesta se fixeaza cu o ata de sutura capatul distal al grefei, brosa se retrage pana cand capatul indoit ajunge la periost, iar capatul proximal al ei se ciupeste. Capatul distal restant al tendonului muschiului flexor profund al degetului mainii se sutureaza cu capatul distal al grefei, iar capatul proximal al grefei se sutureaza cu capatul liber al tendonului muschiului flexor profund al degetului mainii prin doua suturi reciproc perpendiculare dupa Cuneo, care apoi se acopera cu muschiul lumbrical adiacent. Se efectueaza hemostaza, se aplica un drenaj pentru 24 de ore si plaga se sutureaza pe straturi, mana se imobilizeaza cu o atela ghipsata din partea dorsala a acesteia si a antebratului pe 3 saptamani. Peste 3...5 zile dupa imobilizare pe mana se aplica sistemul Kleinert pentru efectuarea miscarilor de flexie in articulatiile degetului operat.The invention relates to medicine, in particular to traumatology and orthopedics, and can be used for the treatment of patients with injuries of the flexor tendon of the fingers. According to the invention, the plastic method of the tendon of the deep flexor muscle of the finger consists in that an incision is made on the palm of the palm, the proximal end of the distal segment of the tendon of the deep flexor muscle of the finger is mobilized, and then an oblique incision is made on the surface. the distal phalanx palm, after which the remaining portion of the tendon of the deep flexor muscle of the finger is removed together with the scar tissues leaving 5 ... 8 mm from the place of fixation of the tendon of the deep flexor muscle of the finger, a silicone tube is inserted in the place of the torn tendon, after which the wound is sutured. Over 5 ... 8 weeks the silicone tube is removed and in the restored osteofibrous canal a graft formed from the superficial flexor tendon or the long palmar flexor tendon is implanted. On the palmar side, in the distal phalanx, through the place of fixation of the tendon of the deep flexor muscle, a brush is inserted under an angle of 55 ... 65 °, open distally, with the externalization of the distal end, which is then bent and it is fixed with a wire from the suture the distal end of the graft, the brush is withdrawn until the bent end reaches the periosteum and its proximal end is pinched. The remaining distal end of the tendon of the deep flexor muscle of the finger is sutured with the distal end of the graft, and the proximal end of the graft is sutured with the free end of the tendon of the deep flexor muscle of the finger through two mutually perpendicular sutures after Cuneo, which is then covered with adjacent lumbar muscle. Hemostasis is performed, drainage is applied for 24 hours and the wound is sutured on the layers, the hand is immobilized with a gypsum splint from the dorsal side of the forearm and for 3 weeks. More than 3 to 5 days after the immobilization on the hand, the Kleinert system is applied to perform flexion movements in the joints of the operated finger.