Simultaneous Combined Surgical Interventions with Use of Microsurgical Technique for Treatment of Severe Limb Injury Sequelae

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Abstract

The authors elaborated new tacktics for simultaneous combined reconstructive operations in patients with severe limb injury sequelae. Experience included 268 patients, aged 13-56, who underwent microsurgical operations for restoration of injuried fragment of the limb. The total number of interventions was 589; altogether 474 tendons (169 patients), 277 nerves (194 patients), 76 arteries (114 patients) were restored. For the correction of secondary neurogenic deformity of fingers and wrist (170 patients) 200 operations were performed. In 50 patients plasty with free vascularized skin-bone grafts was carried out. In 22 patients free skin (18 cases), skin-fascial (2 patients) or skin-tendenous (2 patients) plasty was carried out. In 13 patients total elbow joint replacement using Sivash implant, in 3 patients total replacement of metacarpophalangeal and in 1 patient - matatarsophalangeal joints was performed. In 4 patients transposition of broadest muscle of the back was performed due to sequelae of severe damage of shoulder area or elbow joint. Good and satisfactory results were obtaained in 87.6% of cases.

About the authors

I. G. Grishin

Priorov Central Institute of Traumatology and Orthopedics

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Moscow

I. V. Goncharenko

Priorov Central Institute of Traumatology and Orthopedics

Email: info@eco-vector.com
Russian Federation, Moscow

V. G. Golubev

Priorov Central Institute of Traumatology and Orthopedics

Email: info@eco-vector.com
Russian Federation, Moscow

A. V. Evgrafov

Priorov Central Institute of Traumatology and Orthopedics

Email: info@eco-vector.com
Russian Federation, Moscow

G. N. Shiryaeva

Priorov Central Institute of Traumatology and Orthopedics

Email: info@eco-vector.com
Russian Federation, Moscow

M. M. Bogdashevskiy

Priorov Central Institute of Traumatology and Orthopedics

Email: info@eco-vector.com
Russian Federation, Moscow

M. M. Kroshkin

Priorov Central Institute of Traumatology and Orthopedics

Email: info@eco-vector.com
Russian Federation, Moscow

V. N. Polotnyanko

Priorov Central Institute of Traumatology and Orthopedics

Email: info@eco-vector.com
Russian Federation, Moscow

References

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Radiographs of the feet of patient K. on admission: total defect of the I metatarsal bone of the right foot and deformation of its toes are visible.

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3. Fig. 2. Preoperative radiographs of the right foot with a rod apparatus.

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4. Fig. 3. Scheme of preparation, I metatarsal bone replacement and endoprosthesis of the metatarsophalangeal joint.

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5. Fig. 4. Radiographs of the foot 3 weeks after metatarsal bone defect replacement with a vascularized peroneal graft.

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6. Fig. 5. Eight months after surgery.

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Copyright (c) 1996 Eco-Vector



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