Ruce jsou nedílnou součástí našeho života. Pokud však nastane porucha rovnováhy funkčně-anatomických celků ruky, může dojít k ovlivnění nejen jejich vývoje, ale také k ovlivnění psychosociálního vývoje jedince samotného. Tato kazuistika popisuje úraz batolete elektrickým proudem, kdy při průchodu proudu vznikly hluboké popáleniny v oblasti prstů a dlaně levé ruky, k ožehu obličeje a krátkému bezvědomí. Popisuje jak akutní terapii, tak následnou terapii, rehabilitační péči a komplikace, které v průběhu léčby nastaly.
Hands are an integral part of our lives. However, if the balance of functional-anatomical components of the hand is impaired, what can be affected is not only their development, but also the psychosocial development of the individual itself. The present case report deals with electrical injury in a toddler in whom the current flow resulted in deep burns in the fingers and palm of the left hand, a facial burn, and a short episode of unconsciousness. The article describes acute treatment as well as subsequent therapy, rehabilitation care, and complications that developed during the course of treatment.
- MeSH
- lidé MeSH
- popálení elektrickým proudem * komplikace MeSH
- poranění prstů ruky * etiologie chirurgie komplikace rehabilitace MeSH
- poranění ruky * etiologie chirurgie rehabilitace MeSH
- poruchy růstu patofyziologie MeSH
- předškolní dítě MeSH
- výsledek terapie MeSH
- vývoj kostí fyziologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- Publikační typ
- kazuistiky MeSH
The angiosomal theory and its clinical application is not the latest science discovery. Nevertheless, its importance in plastic reconstructive surgery is still often underestimated when planning surgical procedures. Knowing and understanding the main problem can be useful not only for planning the flap design but also for survival of large flaps and also the wound healing process. Learning more about the complexity of skin and soft tissue anatomy and the vasculatory system can be beneficial for a variety of medical subspecialities. The article is divided into two parts. Part one is an introduction to the history, anatomy and physiology of angiosomes and perforator flaps. The second part describes practical applications in 3 various cases treated at the Department of Plastic and Esthetic Surgery, University Hospital Olomouc.
- Klíčová slova
- angiosome,
- MeSH
- anastomóza chirurgická MeSH
- chirurgické laloky klasifikace krevní zásobení transplantace MeSH
- chirurgicky vytvořené struktury * dějiny krevní zásobení MeSH
- lidé MeSH
- mladý dospělý MeSH
- modely anatomické * MeSH
- modely kardiovaskulární * MeSH
- perforátorový lalok krevní zásobení transplantace MeSH
- plastická chirurgie metody MeSH
- poranění dolní končetiny rehabilitace terapie MeSH
- poranění prstů ruky rehabilitace terapie MeSH
- prsy chirurgie transplantace MeSH
- senioři MeSH
- zákroky plastické chirurgie metody MeSH
- Check Tag
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
Injuries of the flexor finger apparatus are very common. Primarily, it is routinely treated by suture of the tendon. Isolated deep flexor injuries, when the flexion restriction only reaches the DIP joint, are sometimes overlooked by the surgeon or by the patients themselves, especially if the deep flexor is injured, after a closed rupture or cutaneous injury with a small skin wound. The patient is then sent to a department specializing in hand surgery after a few weeks. Subsequent shortening of the tendon apparatus makes flexor suture more difficult or sometimes even impossible. Many ways of suturing the tendons and subsequent treatment are described. The treatment results vary immensely. It depends on the mechanism of injury, injury zone, the suture suture technique used, time that has elapsed since primary treatment, surgeon experience and subsequent postoperative and rehabilitative care. One of them is reconstruction of the flexor apparatus by primary transplantation of an autologous tendon graft. Most commonly, the tendon graft is taken from the palmaris longusfrom the same hand. The tendon graft can subsitute the entire area of zones I and II. The tendon suture is made in the palm proximal to the A1 pulley outside the tendon sheath in the area where the muscular belly of thelumbricalis is located on the tendon of the deep flexor. The distal end is reinserted to the base of the distal phalanx. The primary use of the autologous tendon graft can be used in the reconstruction of obsolete deep-flexor injuries in Zone II, but also in primary treatments. This type of treatment has a number of advantages. Performing the reinforcement of the tendon at the base of the distal phalanxand the suture in the palm of the hand completely eliminates the complications caused by the tendon suture in zone II. There is no injury to the tendon sheath, or the need for intersection of the tendons. The transplanted tendon is smaller in diameter than the deep flexor, so it can also be used for older injuries when the tendon sheath is in partially missing. It removes painful palmar resistance by restoring the right position and a tension of tendon of lumbricalis and the tendon of the deep flexor. This type of reconstruction allows immediate active or semi-rehabilitation of the hand and fingers. Key words:tendon, injury, hand, transplantation, surgery, flexor, reconstruction, rupture, treatment.
- MeSH
- autologní štěp transplantace MeSH
- kosterní svaly chirurgie MeSH
- lidé MeSH
- poranění prstů ruky rehabilitace chirurgie MeSH
- poranění ruky patologie rehabilitace chirurgie MeSH
- poranění šlachy chirurgie MeSH
- prsty ruky patologie transplantace MeSH
- rozsah kloubních pohybů fyziologie MeSH
- ruptura patologie chirurgie MeSH
- šicí techniky normy MeSH
- šlachy patologie transplantace MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
