TENDON-MUSCLE TRANSPOSITIONS IN THE REHABILITATION OF PATIENTS WITH DYSFUNCTIONS OF THE HAND AND FINGERS
Objectives. To assess the clinical efficacy of muscles and (or) tendons transposition in the rehabilitation of patients with the sequelae of wrist tendons and upper limb nerves damages. Material and methods. We studied the experience of medical rehabilitation of 118 patients with old injuries of flexor tendons, extensor tendons, combined injuries of flexor tendons and nerves, dysfunctions of the hand and fingers which occur in case of the radial nerve damage. The method of transposition of different tendons and (or) muscles was used in the treatment of all patients. Results. It was found out that the recovery of motor function of the hand and fingers in victims with injuries of the flexor tendons and extensor tendons was full and made up 75-80% of the normal range of motion, grasping power was reduced. In patients with the sequelae of combined injuries of flexor tendons and nerves a complete recovery of joint movements in the second - the third fingers and the fourth - the fifth fingers was observed after transposition. The development of secondary neurogenic deformations of the hand required the correction in the remote period. Functional recovery of extension in the first - the fifth fingers took place in its entirety both in the transposition of the synergist and antagonist, but in different terms. Conclusions. Using the transposition of healthy muscles with good contractility to restore or improve the motor function of the hand fingers in chronic lesions (defects) of tendons and nerves is the most effective and economically sound method of medical rehabilitation.