Clincal Study Of Treatment Of Joint Injury In Hand With Prosthetic Replacement

There are a lot of injuries in hands with the development of economy every year,in which joint injuris are often been seen. There are not satisfying treatmental method in clinical work,though the requires of paitents are higher. There are joint fusion,joint plastic operation,cartilage transplant,heterologous joint transplant,free joint transplant,prosthetic replacement etc in the past years. Prosthetic replacement is used less and doctors are short of clinical experiences and study materials. Some docters began to study prosthetic replacement in hands following the mature of prosthetic replacement in lower limb,it went through prosthesis design,clinical test,and now go into the stage of primary apply. Our department doctors select and do operations for 5 cases which have joints injuris and rigor dysmorphosis. We attempt to accumulate experiences and find and discuss problems which we met in preoperation,itraoperaion,postoperation,then do some works for the apply and generalization of prosthetic replacement .Objective: Discuss the methods and clinical effectiveness of joint injury in hand with prosthetic replacement .Methods:From November 2005 to January 2007,five patients with joint injuris in hands were treated by Swanson joint prosthetic replacement. Reusults The follwed up time was from 5 months to 18 months ,to assess according to assessment standard described by Gu.Postoperative objective detect indication:1. measure the ROM,pinch power,grip power of the joint both preoperative 24hours and postoperative 12 weeks,observe the reconstitution of pain and deformity.2. the postoperative complication and the remedy.3. the method and effect of postoperative exercise. The convalescence of normal work.4. The patient are satisfied to the operation?5.visit the difference of manual worker and unmanual worker , and the longevity of prosthesis.Study content:1.the indication,contraindication,comlication of operation.2.operative method.3.the best time of postoperative treatment and exercise.4.assess the funcation of joint both preoperation and postoperation5.the difference of manual worker and unmanual worker to the operation.6.the study longevity of prosthetic in hand. Results: Treatment outcome was excellent in 1 finger, good in 2 fingers, general in 1 finger, poor in 1 finger. The goodness ratio is 60%.The postoperative incisional heal of 4 cases are good, and1 is poor. There are not radial or ulnar deformation . There is pain when the joint acts in 1 case. There is improvement in the ROM,pinch power,grip power of the joint. There is not patent difference in sense.4 cases went to work after postoperative 3 months. 3 cases are satisfied with the operation. Unmanual workers are better than manual worker in the clinical effectiveness. We do not find aging,deformation,loosening. The joint activity of early postoperative in3 cases patiences is good,but we find there is the trend of reducetion by visiting in postoperation.Conclusion: Swanson Joint prosthetic replacement has good general effectiveness to treat joint injury in hand,The injury joint activity is repaired better ,it is advantageous to the people which are engaged in fine job. The joint stability is good,the risk of operation is low. The secondary injury is little,and is apt to remedy. There is the trend of reducetion by visiting in postoperation, it indicates that we should put an important role to operative indication and conditioning. On the orther hand,it is short of clinical experiences and study materials about postoperation and preoperaion. We hold the cautious attitude to joint prosthetic replacement,but we belive it will be generally applied with the more studies.