Find both ends of the damaged tendon and laid block weld Bennelyu. If the wound does not show a central end, you can try to pull it out of bone and fibrous channel. In this case, the hand and the fingers will penetrate as flex and special tweezers between the two legs of the flexor surface.
Tenodons nail bone.
Distal end of the deep flexor cross stitch. Go through the middle of the middle phalanx drill with a thin oblique hole. Nail phalanx bent at an angle of 35-40 °, and hold the ends of the strands through the passage and is attached to a button on the back surface of the phalanx.
Arthrodesis of the distal interphalangeal joint.
Excised joint capsule and cartilage removed from the respective joint surfaces. Distal phalanx in maintained at a diffraction angle of 20 ° with one or two K-wire transarticular fixed. Knitting needles are removed after 3-4 weeks.
Recovery of the deep digital flexor tendon in the plane of the proximal half of the middle phalanx of the fingers.
Damage to the deep flexor tendon at the level of the middle phalanx of the fingers are in serious injury, since suture the tendon at this level can technically difficult, often develop adhesions. Produce a Z-shaped incision of the skin and subcutaneous fatty tissue at the level of damage to the tendon. In the event of excessive movement of the proximal end portion of the tendon can be extended proximally carefully without damage important anatomical structures. Find the proximal end of the tendon, which is performed by the synovial vagina. Impose Bennelyu block seam. Superficial flexor tendon can be cut, if it is damaged at the level of the middle phalanx. Skin wound sutured with interrupted sutures. Blocking suture removed after 4-5 weeks, that is, such as the adhesions tendon. In the period of treatment should continue in the passive movement interphalangeal joints.
Restoration of the extensor tendons of the thumb.
Usually occurs in the lower portion of the fracture of the radius. In this area, the average length of 5 cm make dissect tendon sheath distal end are torn tendon. Central end of the tendon, usually moved proximally, and then the incision must be extended upward. After the discovery of the central end of its refreshing and seam or Kuehne Bennelyu. If the ends of the tendon can not pull together, we produce plastic with autologous tendon of the palmar muscle removed.
Restoration of the flexor tendons of the thumb.
Attraction of the flexor tendons of the thumb rest depends on the level of injury. Section can be carried out on the radial surface at the base of the phalanx be extended laterally on metacarpophalangeal joint, and further along the palmar crease, bordering the muscles of the thenar eminence. Aponeurosis dissection of the hand and short flexor muscle of the thumb abduction provides good access to the outside of the long flexor tendon of the thumb. During the manipulation distal flexor retinaculum with superficial palmar arterial arch and the branches of the median nerve carefully. The tendon is restored by suturing.
I open reduction finger.
Indications - nevpravimye and chronic sprains. Bayonet on the palmar surface of the metacarpophalangeal joint naked, I cut my finger. Section of the joint capsule, free base of the phalanx and the head of the metacarpal bone. Violation of the flexor tendon of the thumb release. Restore the anatomy of the proximal phalanx and metacarpal. Produce transarticular K-wire fixation. The capsule is sutured. Wound sutured in layers. A plaster cast for 3 weeks.
Open reduction interphalangeal finger Luxation.
Nach away opening the corresponding knuckle cut out scar tissue capsule interponirovannye areas. Spoke produce temporary transarticular fixation. The wound is closed. Brushes give a sublime. Around the wound - cold for 24-48 hours
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