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8DOI: 10.24411/2181-0443/2020-10165 СОВРЕМЕННЫЕ МЕТОДЫ ЛЕЧЕНИЯ ДЕТЕЙ С ПОСЛЕОЖОГОВЫМИ РУБЦОВЫМИ КОНТРАКТУРАМИ ПЛЕЧЕВОГО И ЛОКТЕВОГО СУСТАВОВ
Абдурахманов Ф.С., Кетмонов А.Г., Мирзакаримов Б.Х., Абдукодиров С.А.
В настоящие время число лиц, страдающих от последствий ожогов, продолжает неуклонно расти. Рубцовые контрактуры плечевого и локтевого суставов по анатомическому месторасположению разделяются на: краевой, средний и тотальные виды.
У детей с послеожоговыми контрактурами плечевого и локтевого суставов, наблюдаеются психоэмоциональные нарушения и остставание в развитии среди роветсников.
Ключевые слова: сустав, плечо, локти, рубцы, ожог, детский возраст.
БОЛАЛАРДА КУЙГАНДАН КЕЙИНГИ ЕЛКА ВА БИЛАК СОХАЛАРИ ЧАНДЩЛИ
КОНТРАКТУРАЛАРИНИ ДАВОЛАШНИНГ ЗАМОНАВИЙ УСУЛЛАРИ
Хозирги кунда куйиш оцибатларидан азият чекаётганлар сони ортиб бормикда. Елка ва билак бугимларининг чандицли контрактураларини анатомик жойлашиши буйича куйдагиларга булинади: четки, урта ва тотал.
Болаларда куйгандан кейинги елка ва билак бугимлари контрактуралари, уларда психоэмоционал бузилишларга х,амда ривожланишда тенгдошларидан ортда колишга олиб келади.
Калит сузлар: бугим, елка, тирсак, чандиглар, куйиш, болалар.
MODERN METHODS OF TREATMENT OF CHILDREN WITH POST-BURN CURRIC CONTRACTURES OF THE SHOULDER AND ELBOW JOINTS
The number of people suffering from the consequesnces of burn continues to grow steadily. Cicatrical contractures of the shoulders and elbow joints by anatomical location are diveded into: marginal.middle and total types.
In children with post-burn contractures of the shoulder and elbow joints psychoemotional disorders and devolepmental delay among peers are observed.
Key words: Shoulder, post burn scar, Scars, elbows.
The urgency of the problem. According to the WHO, every year, per 100,000 population, 294-384 people are affected by burns, i.e. 3.8%. In our republic, this figure is 2.3%. During the set d of cases after healing of a burn wound patients at the head, neck, body, upper and lower extremities develop scar
deformation and contracture. According to the authors, contracture of the shoulder joint is 10-37%, the elbow joint
- 7-28% of all contacts of large joints [1,2,3,].
Cicatricial contractures of the shoulder and elbow joints by anatomical location are divided into: marginal, middle and total types. By type of dysfunction of the joints are divided into: I degree, II degree, III degree. In many cases, totally located scars lead to impaired function of
the II and III degrees [4].
Children with post-burn contractures of the shoulder and elbow
joints, there are psycho-
emotional e violations and
gaps e development among
rovestnikov. This, in turn, leads to a violation of the way of life, working
capacity and when knowledge in institutions. Patients hope for cure [3].
Materials and methods. Currently, the of Maxillofacial Plastic Surgery Andijan children's multidisciplinary
acquiring educational lose
research
Department and regional center
spend Xia new modern methods of restorative plastic surgery post-burn rub tsovyh strain. From 2017 to 2019, more than 100 children with post-burn scar contractures of the joints were operated on. Of these, we observed 62 patients with post-burn cicatricial contractures of the shoulder and elbow joints. The age of these patients varied from 2 to 16 years, girls were 24, boys - 38. Together with general clinical research methods, the patients underwent radiography of the shoulder and elbow joints, determination of the amount of oxygen in the tissues (PtcO 2 ).
Results and their
discussion. We know, that the contracture of the shoulder and elbow joints, using traditional methods ( the Z -Plastic, plastic flap, free autodermoplasty, combined plastic ) operations.
We performed "Z" operations for post-burn flexion contractures of the shoulder (in 5 patients) and elbow (in 4 patients) joints. Have In 3 patients, the wound healed with scarring after necrosis of the flap edges, due to impaired blood supply. This has resulted in relapse and disease.
In 3 patients with post-burn contractures of the shoulder and elbow joints, carried out the operation with the help of a
scrappy second plastic and. One (33.3%) patient had deformities in the joint area due to the excess thickness of the flap
and aesthetic deficiencies in the donor area.
After the operation using free autodermoplasty, 11 patients with totally located post-burn contractures of the shoulder and elbow joints, in 3 (27.2%) patients, repeated contracture was observed due to skin wrinkling, which was taken with a dermatome.
By Combination Card about wa nn nd plastic as well, ie, plastic surgery with local tissues and free
autodermoplasty in 13 patients with totally located post-burn contractures of the shoulder and elbow joints, in 3 (23%) patients gradual deformation of this area was observed.
All the above methods of surgery, being traditional methods, have several disadvantages (graft retraction, skin wrinkling, necrosis of a part of the flap, hyperpigmentation, etc.). Taking into account all these shortcomings, we proposed a new modern method of eliminating post-burn cicatricial contractures of the shoulder and elbow joints by the method of free full-thickness skin autograft. This method was used to operate 26 patients with totally located post-burn cicatricial flexion
contractures of the shoulder and elbow joints.
Operation technique:
the medium and totally located pulling scars in the fossae of the shoulder and elbow
joints are excised. Hemostasis. Produced a small joint
redressatsiya. C. Creating Single wounds and closes polnosloynoy free wheel, which was taken from the groin with a scalpel, with all E layer s skin, and
purified by subcutaneous adipose tissue. A pressing furacillin bandage is applied to the wound. The donor wound is sutured using the "acute dermotension" method. The graft pressure bandage is removed on day 67. All patients, during and after the operation for 2-3 days, receive antibiotic
therapy, and in the postoperative period, physiotherapy and
balneotherapy are carried out.
method, there was a relapse of contracture due to lysis of the graft.
Conclusion. The results of the study show that 25 (96.15%) patients have functional restoration of joints, return to work and good results.
Only in 1 patient, when the cicatricial contracture of the shoulder and elbow joints was eliminated by this
Literature.
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