Analysis of Damage in Patients with Injury Entrenched Distal Upper Limb

Аbramov V. V., Kanyuka E. V., Nekhanevich О. B.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

At present, the frequency of injuries and diseases of the musculoskeletal system has a tendency to grow, both in Ukraine and abroad. Also, a high percentage of disability of persons with the consequences of injuries and diseases of the musculoskeletal system. In Ukraine, disability due to injury ranks third after diseases of the circulatory system and cancer. Upper extremity injuries are the cause of disability in 30 % of cases (including injury brush in 13 % of cases). Hand because of its specificity as a body of work and, especially, its distal departments that are responsible for the subtle movement coordination, fine motor skills, are often subjected to daily damage, industrial and domestic human activities. In Ukraine, upper limb injuries are the second largest of all injuries. Treat­ ment and rehabilitation of injuries of the upper extremities is difficult not only medical but also social and economic problem. Apart from treating the consequences of the trauma in the form of restoration of the anatomical integrity of the damaged structures is of great importance and restoration of disturbed functions of the limb. Training in self­ service, the patient returned to work is of great socio­economic importance for society. Applied treatments require long periods of hospitalization and entail long disability. Long periods of disability and a large percentage of output affected by disability are significant economic costs that forced society incurs as a result of injuries and diseases of the distal portions of the upper limbs. Given the significant role of the consequences of injuries and diseases of the distal portions of the upper limbs in patients Disability advisable to create individual rehabilitation programs for sick and disabled people in this pathology. The need remains to improve the effectiveness of rehabilitation of sick and disabled with the consequences of injuries and diseases of the distal portions of the upper limbs, the creation of individual rehabilitation programs , objective criteria Disability and their introduction into the practical work of medi­ cal institutions , as well as medical and social expert commissions. The aim of this study was to analyze the structure of lesions in patients with old injuries of the distal portions of the upper limbs. Object and methods. We analyzed data from 917 patients effects of trauma and orthopedic diseases of the upper limbs, which were treated in the study of physiotherapy and sports medicine clinic of the State Institution “Ukrainian State Scientific­Research Institute of Medical and Social Problems of Disability Ministry of Ukraine” for the period 2010­2013. Method to the copy of the medical records we obtained data on the structure of the upper extremities injuries, age, sex , duration of disease patients. Statistical processing of the results was performed using the package licensed programs STATISTICA (6.1, serial number AGAR909E415822FA). Analyzed form of the distribution parameters using the W- Shapiro-Wilk test. Determined the significance of differences between the in- dices based on the type of distribution using the Student t-test , U-Mann- Whitney and chi-square Pearson. Thresh- old level of statistical significance took p < 0.05. Results and Conclusions. Thus, the analysis of the structure damage in patients with traumas of distal sections of the upper limbs, the following conclusions: 1. Data obtained from the analysis of categories of patients with se- quelae of injuries of distal sections of the upper extremities receiving rehabilitation treatment at the clinic of the In- stitute, relevant statistical indicators as reflected in the literature. 2. Been an increase in the number of patients with injuries of the distal parts of the upper limbs in an average of 20 %. Number of patients with disability group is 17 %. Dominated by male patients – 64 %, as well as urban residents – 77 %. Patients who were not employed – 52 % of working age – 89.5 %. Among the causes of upper extremity injuries predominated household injuries in 76 % of cases. 3. Prescription of injury for more than 1 year was observed in 75 % of cases. 4. Among the damage of the distal portions of the upper limbs on the basis of anatomical damage prevailed tendon unit – 24 % and peripheral nerves – 14 % of cases. Soft tissue in the observation group were damaged in the proximal and distal parts of the upper limb in 37 % of cases, lesions of the distal portions – in 43 % of cases, respectively.

disability, injury, upper limb rehabilitation

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«Bulletin of problems biology and medicine» Issue 3 part 2 (111), 2014 year, 101-105 pages, index UDK 616­001. 1: 616. 717. 7­9