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Амплитудно-силовые характеристики кисти в процессе реабилитации больных после шва нервов, сосудов и сухожилий на уровне нижней трети предплечья

Амплитудно-силовые характеристики кисти в процессе реабилитации больных после шва нервов, сосудов и сухожилий на уровне нижней трети предплечья

Abstract

The assessment of the amplitude of the motion and force of the hand in 3 weeks, 3, 6 and 12 months after surgery was performed within the process of rehabilitation of 81 patients after surgical repair of the median and (or) the ulnar nerve, flexor tendons and the ulnar artery at the level of the lower third of the forearm. The most significant decrease in the amplitude of movements in comparison with other groups, was found in the patients after suturing both nerves, vessels and tendons. Amplitude of motion was restored in patients after an isolated interruption of the median nerve in 6 months after suturing in patients after combined injury of the median nerve and flexor tendons, the ulnar neurovascular bundle and flexor tendons – in 12 months after the operation, a slight limitation of movement in patients after suturing both nerves maintained. Indicators of dynamometery of the hand do not exceed 30-50% of normal even after a year later. It that The strength of the hand was revealed to be higher within the observational period in patients who’d undergone bypass of ulnar artery than in patients who underwent ligation of it. This indicates that the reconstruction of the ulnar artery influences positively to the restoration of hand force, and hence, to the process of nerve regeneration.

В процессе реабилитации 81 пациента после хирургического восстановления срединного и (или) локтевого нервов, сухожилий сгибателей и локтевой артерии на уровне нижней трети предплечья проведена оценка амплитуды движений и силы кисти через 3 недели, 3, 6 и 12 месяцев после операции. Наиболее значительное снижение амплитуды движений по сравнению с другими группами выявлено у пациентов после шва обоих нервов, сосудов и сухожилий. Амплитуда движений восстанавливалась у пациентов после изолированного перерыва срединного нерва через 6 месяцев после его шва, у больных после сочетанного повреждения срединного нерва и сухожилий сгибателей, локтевого сосудисто-нервного пучка и сухожилий сгибателей – через 12 месяцев после операции; сохранялось незначительное ограничение движений у больных после шва обоих нервов. Показатели динамометрии кисти даже через год не превышали 30-50% от нормы. Выявлено, что сила кисти на протяжении наблюдения выше у пациентов, которым выполнена пластика локтевой артерии, чем у пострадавших, которым выполнена ее перевязка. Это свидетельствует, что реконструкция локтевой артерии положительно влияет на восстановление силы кисти, а следовательно, на процесс регенерации нерва.

Keywords

ДВИГАТЕЛЬНЫЕ НАРУШЕНИЯ, ТЯЖЕСТЬ ТРАВМЫ, ДЕНЕРВИРОВАННЫЕ МЫШЦЫ, СИЛА КИСТИ, АМПЛИТУДА ДВИЖЕНИЙ, ЛОКТЕВАЯ АРТЕРИЯ, СУХОЖИЛИЯ СГИБАТЕЛЕЙ, ИЗОЛИРОВАННЫЕ И СОЧЕТАННЫЕ ПОВРЕЖДЕНИЯ НЕРВОВ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
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