The surgical treatment of outcomes of intra-articular injuries and diseases of joints of fi ngers of hand

Among traumas of hand 41% constitute injuries of joints. The aftermath of their incorrect treatment (wrongly healed fracture, ankylosis, contracture, joint defect) significantly decrease quality of life of patient. Also, huge percentage of injury of joints is observed under rheumatoid arthritis, pyo-septic diseases and various types of arthrosis. The following methods of surgical treatment of outcomes of intra-articular injuries and diseases of joints of fingers of hand were applied at different stages: arthroplastic, osteosynthesis with Kirschner's wire, plates, wire, apparatus of external fixation, early activation and lasting immobilization. The every of mentioned methods has its own shortcomings impacting results of treatment. In comparison, the method of distraction applied in the clinic since 1968, has a number of advantages which make it possible in a most effective way to cope with arthrogenic contractures and intra-articular injuries. The results of treatment of 74 patients residing in the clinic from January 2005 to December 2011 were analyzed. The injuries of metacarpophalangeal articulations were observed in 29 patients and injuries of interphalangeal joints - in 45 patients. The defects of joints were detected in2 patients. The wrongly healed fractures were detected in 10 patients. The arthrogenic contractures were detected in 56 patients, ankylosis in 2 patients and deforming/post-traumatic arthrosis in 4 patients. In all cases the distraction apparatus with subsequent dosed distraction was used. The received positive results of treatment (96.8%) confirm high effectiveness of application of method of distraction in treatment of aftermath of intra-articular injuries and diseases of joints of fingers of hand.

rheumatoid arthritis, distraction apparatus, distraction, hand, arthrosis, contracture, ankylosis