FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to reconstructive hand surgery, and can be used to restore the hand grasping function in the presence of stems 1–4 of metacarpal bones at the level of proximal thirds. On the end of the stumps, a volume reserve of soft tissues is formed by transplantation of the skin-fat flap. Between intramedullary distracting spokes with hook-bent proximal ends and bases of metacarpal stumps there is a metal washer of rectangular shape. Stumps are distracted with their movement into the formed soft-cloth frame. After distraction is completed, a cement spacer is placed in a distraction defect. After 2 months, the spacer is removed. Distraction defect is replaced by a cortical-spongy allograft, the size of which is equal to the dimensions of the spacer. Transplant is covered with capsule formed around spacer. Skin wound is closed above it.
EFFECT: method enables to create optimal conditions for consolidation, transplant reconstruction of required value and healing of postoperative wound under ischemic conditions of soft-tissue and bone receptive bed due to the fact that the graft is surrounded from all sides by well-supplied blood tissues: formed connective tissue capsule and transplanted skin-fat flap.
1 cl, 5 dwg, 1 ex
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Authors
Dates
2019-05-06—Published
2018-11-12—Filed