METHOD FOR SURGICAL MANAGEMENT OF CICATRICAL ADDUCTOR CONTRACTURE OF FIRST METACARPAL BONE Russian patent published in 2019 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to reconstructive hand surgery, and can be used for surgical management of cicatrical adductor contracture of first metacarpal bone. Method involves excision of scars in the area of the first intermittent space, formation of a back U-shaped skin-fat flap with a proximal base, maximum retraction of the first metacarpal bone, laying of the U-shaped flap into the area of the inter-cavity space. On the rear surface of the main phalanx of the second finger and the second interstatic gap, a bipolar asymmetrical axial lingo-skinned fasciocutaneous flap is formed. When it is formed, an incision is made along the dorsal-radial surface of the second finger, starting from the level of the distal interphalangeal joint and continuing to the base of the second metacarpal bone in its projection parallel to this incision. 2 cm from the main phalanx and 3 cm in the metacarpal region, similarly formed incision on the dorsal-ulnar surface of the main phalanx of the second finger and in the projection of the third metacarpal bone, distal and proximal ends of the incisions are arched together with involvement in the distal and the proximal parts of the dorsal hypodermic veins flap. Donor wound is connected to the recipient on the level of the metacarpal phalangeal joint of the second finger, the wound edges are mobilized, the formed flap is mobilized, after which the distal portion of the flap is moved into the tissue defect along the lateral surface of the metacarpal joint of the second finger, proximal portion of the flap is moved to the bottom of the interdigital space, and the U-shaped flap is closed tissue defect on the medial surface of the metacarpal phalangeal joint of the first finger. Donor's wound on the first finger and on the rear of the hand is closed primarily.

EFFECT: method provides prevention of recurrent contracture of first metacarpal bone, reduced donor defect and reduced length of treatment due to formation of first interdigital space of several skin flap.

1 cl, 3 dwg, 1 ex