FIELD: medicine.
SUBSTANCE: destruction of chords is performed by transcutaneous introduction of needles. Before operation high-frequency Doppler examination of affected palm in supposed points of needle introduction is carried out, points, free of vessels, outside formed white-coloured zones of ischemia, outside folds and nodes on palm, as well as part of skin, tightly commissured with palmar aponeurosis, are marked. With introduction of anaesthetic hydropreparation is realised, skin is exfoliated from scar-modified ray of palmar aponeurosis, points of anaesthetic introduction correspond to ports, marked for introduction of needles; in the process of dissection of bands of palmar aponeurosis ends of needles are moved in three planes - vertical, horizontal and sagittal. Movements of needle do not exceed 2-3 mm. To dissect thin and flat bands pendulum-like movements with needle are realised, in the process of dissection of thick bands and nodes frequent movements of needle in vertical plane are used. After operation at night time immobilisation of palm with gypsum splint is realised, with stopping immobilisation at day time and carrying out active bending and unbending in joints of fingers. Patients begin self-catering and everyday loadings the following day, starting hard physical exercise and return to labour five days after operation.
EFFECT: method will make it possible to reduce rehabilitation treatment terms, reduce risk of complications, associated with injury to tendons and vessel-nerve bundles.
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Authors
Dates
2015-12-10—Published
2014-08-19—Filed