Pavel A Matveev, traumatologist-orthopedist; Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: firstname.lastname@example.org; https://orcid.org/0000-0002-0455-740X.
Ludmila M Smirnova, Grand PhD in Engineering sciences, leading researcher of the Department of Biomechanical Studies of the Musculoskeletal System of Institute of Prosthetics and Orthotics, Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; Professor of Department of Biomedical Engineering, St. Petersburg Electrotechnical University “LETI”, 5 Professora Popova Street, 197376 St. Petersburg, Russian Federation; e-mail: email@example.com; https://orcid.org/0000-0003-4373-9342.
Igor V Shvedovchenko, MD, Grand PhD in Medical sciences, Professor, Scientific Supervisor of the Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: firstname.lastname@example.org; https://orcid.org/0000-0003-4618-328X.
Andrey A Koltsov, PhD in Medical sciences, Head of the First Child’s Traumatology-Orthopedic Department, traumatologist-orthopedist, pediatric surgeon of the Albrecht Federal Scientific Centre of Rehabilitation of the Disabled, 50 Bestuzhevskaya Street, 195067 St. Petersburg, Russian Federation; e-mail: email@example.com; https://orcid.org/0000-0002-0862-8826.
In the heading: Original researches
Year: 2023 Volume: 5 Journal number: 1
Article type: scientific and practical
Introduction. Habilitation of patients with reduction hand anomalies in children is an important task, the success of which depends on the degree of integration into society, socialization and quality of life in general. One of the methods of treatment is non-blooded toe phalanges autotransplantation. At the same time, the question of the effect of the operation on the function of the hand and further life activity remains insufficiently studied.
Aim. The aim of the study is to conduct a comprehensive assessment of the results of surgical treatment of the hand by non-blooded toe phalanges transplantation in children.
Materials and methods. We examined 34 patients with reduction hand anomalies who received surgical treatment by non-blooded toe phalanges autotransplantation in the clinic of the Albrecht Federal Scientific Centre of Rehabilitation of the Disabled in the period from 2013 to 2022. The study took into account the data of clinical examination, the results of radiation diagnostics, questionnaires using the questionnaires DASH and AbilHand -Kids. A comprehensive assessment of the obtained data was performed using the Brief International Classification of Functioning, Disability and Health Core Set for Hand Conditions to assess the condition of patients with upper limb malformations.
Results. The severity of impairments in the structure of the hand, the functions of mobility and stability of the joints, the indicators of the potential ability of activity and the participation of patients with deformities of the hand before and after the start of treatment were assessed. The obtained estimates are expressed using the conceptual language and scales of the International Classification of Functioning, Disability and Health. Analysis of the results with a quantitative assessment confirmed the reduction of structural hand disorders achieved with the help of surgical treatment, improvement of mobility and stability of the joints of the affected rays of the hand in case of hypoplasia, brachydactyly and ectrodactyly. An increase in the potential ability of activity and participation of patients after surgical treatment of reduction hand anomalies by the method of non-vascularized toe phalanges autotransplantation was revealed.
Discussion. As a result of the treatment, children achieved a higher ability to perform or cope with the task or action without auxiliary means or outside help, in particular at home and in everyday life, when performing actions involving fine motor skills of the hand, with the need to exert effort, in self-service. The increase in the level of the potential ability and participation of the child is explained by the achieved increase in the mobility and stability of the joints of the affected rays of the hand, and the improvement of these functions of the hand is due to the normalization of its structure as a result of surgical treatment.
Conclusion. It is advisable to evaluate the results of surgical treatment of reduction hand anomalies by nonblooded toe phalanges autotransplantation using the International Classification of Functioning, Disability and Health and a set of methods, including clinical examination, radiography, computed tomography, questionnaires on DASH and AbilHand – Kids questionnaires before and after treatment. A comprehensive evaluation of the results of surgical treatment of reduction hand anomalies confirmed the pronounced positive functional effect of the method of non-blooded toe phalanges autotransplantation, which is expressed in improving the state of the structure and functions of the hand, increasing the potential ability of activity and participation of patients, and their quality of life.
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