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Pollisizasyon, tendon grefti ve radial önkol flebi ile her iki elde tek seanslı rekonstrüksiyon

Reconstuction of both hands using pollicisation, tendon grafts and radial forearm flap in one stage.

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Abstract (2. Language): 
A fifty two year old woman sustaining bilateral hand injurles after a traffic accident was admitted to our clinic. She had right thumb amputation from the carpometacarpal level, tendon and skin loss in the right hand secönd finger, loss of the 2-3 extensor tendons and the overlying dorsal skin in the ieft hand. Reconstruction in a singie session was planned and palmaris longus tendons from both hands were taken and used as intercalary grafts for extensor tendon losses after which the skin loss was covered with a radial forearm flap. Aftervvards, the second injured finger in the right hand was taken and pollicisized using the Buck Gramcko technique. At the iast follow-up examination 8 months after the injury, she was able to pick up small objects and grip large and heavy objects using her right hand. The range of motion of the wrist and the fingers of the İeft hand was completely restored. The importance of treatment design tailored individually for each patient was stressed in this case.
Abstract (Original Language): 
Trafik kazası sonrası her iki el yaralanması ile kliniğimize başvuran 52 yaşındaki bayan hastada karpometakarpal seviyeden sağ el başparmak amputasyonu, aynı el ikinci parmakta cilt ve tendon kaybı, sol el dorsalinde cilt ve 2-3. parmak ekstensör tendon kayıpları tespit edildi. Tek seansta rekonstrüksiyon planlanarak, sol elde palmaris longus îendonlarından alınan greftler uygun gerginlikte ekstensör tendon kayıplarının yerine interkalari greftler olarak tatbik edildi. Ardından cilt defekti için ters akımlı 'radial forearm Hep' tasarlandı ve yara örtüldü. Takiben sağ el ikinci parmak alınarak Buck-Gramcko'nun taht ettiği teknikle başparmak yerine transfer edildi. Sekiz ay sonra yapılan kontrolde hastanın sağ elini kullanarak küçük cisimleri tutabildiği, ayrıca geniş ve ağır cisimleri kavrayarak kaldırabildiği görüldü. Sol elde ise bilek ve parmak hareket genişlikleri tam olarak kazanılmıştı. Klasik yoldan farklı tedavi edilen bu vakada tedavinin hastaya göre planlanması gerektiği bir kez daha vurgulandı.

REFERENCES

References: 

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