Treatment and Rehabilitation of Professional Local Radiation Injury of the Hand, Using the Method of Transplanting the Toe to the Hand
- Authors: Aksenenko A.V.1, Samoilov A.S.1, Parinov O.V.1, Bushmanov A.Y.1, Galstyan I.A.1, Zavialov A.A.1, Zimnikov G.E.1, Kolyadin S.G.1, Trofimenko Y.G.1, Stepanyanc N.G.1, Baksiyan G.A.1, Astahov D.N.1, Zugumova M.S.1
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Affiliations:
- A.I. Burnazyan Federal Medical Biophysical Center
- Issue: Vol 69, No 6 (2024)
- Pages: 33-37
- Section: Radiation Medicine
- URL: https://bakhtiniada.ru/1024-6177/article/view/363958
- DOI: https://doi.org/10.33266/1024-6177-2024-69-6-33-37
- ID: 363958
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Abstract
Purpose: To introduce a wide range of specialists with the technique of reconstructive plastic surgery, which was first used in local radiation injury (LRI).
Material and methods: clinical analysis of the case histories of the severe LRI of the hand. The report describes the results of the first autotransplantation of the II toe in the position of the right hand III finger for the restoration of grip function in LRI.
Results: Patient L., 38 years old, was admitted to the A.I. Burnazyan Federal Medical Biophysical Center in 2010 for the treatment of late consequences of severe LRI of the right hand resulting from contact with a gamma radiation source (Ir 192) in 2008. In the period from 2010 to 2018, the patient underwent repeated surgical operations, including reconstructive plastic surgery, which made it possible to achieve healing of constantly recurring late radiation ulcers. However, multiple necrectomies, exarticulations, finger amputations and resections of the phalanges led to the formation of a functionally defective hand and persistent disability of the patient. In 2018, the patient was admitted to the clinic for reconstructive surgery to restore the function of hand grip - microsurgical transplantation of the II toe into the position of the III finger of the hand. As a result of the treatment, the function of grabbing objects with the right hand was restored, and the patient’s ability to work was largely restored.
Conclusions: The obtained long-term functional and aesthetic results allow us to consider the applied method of fingerless hand reconstruction by autotransplantation of the toe with the imposition of microvascular anastomoses optimal. It is advisable to use this type of surgical treatment more widely for the rehabilitation of patients with severe and extremely severe hand LRI.
About the authors
A. V. Aksenenko
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
A. S. Samoilov
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
O. V. Parinov
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
A. Yu. Bushmanov
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
I. A. Galstyan
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
A. A. Zavialov
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
G. E. Zimnikov
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
S. G. Kolyadin
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
Yu. G. Trofimenko
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
N. G. Stepanyanc
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
G. A. Baksiyan
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
D. N. Astahov
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
M. Sh. Zugumova
A.I. Burnazyan Federal Medical Biophysical Center
Email: micsurg@yandex.ru
Moscow
References
- Radiatsionnaya Meditsina = Radiation Medicine. A Guide for Medical Reserchers and Health Care Organizers. 4-vol set. Ed. Ilyin LA. Vol. 2. Radiatsionnyye Porazheniya Cheloveka = Human Radiation Damage. Moscow Publ., 2001. 161 p. (In Russ.).
- Milanov NO, Shilov BL. Plasticheskaya Khirurgiya Luchevykh Povrezhdeniy = Plastic Surgery Radiation Burns. Moscow, AIR-ART Publ., 1996. 99 p. (In Russ.).
- Milanov NO, Filippov VV, Zelyanin AS., Nadezhina NM, et al. Microsurgical Autotransplantation of Tissues as a Pathogenetic Method of Treatment of Patients with Local Radiation Injuries. Khirurgiya. Zhurnal im. N.I.Pirogova = Surgery. Journal named after N.I.Pirogov. 2012;8:4-8 (In Russ.).
- Petrovskiy BV., Krylov VS. Mikrokhirurgiia = Microsurgery. Moscow, Nauka Publ., 1976. 187 p. (In Russ.).
- Samoylov FS, Bushmanov AY, Galstyan IA, et al. Local Radiolesion in X-Ray Inspection Specialists. Radiatsionnaya Dozimetriya = Radiat Prot Dosimrtry. 2016;171;1:117-120 (In Russ.). DOI:https://doi.org/doi:10:1093/rpd/ncw203(In Russ.).
- Cobbett JR. Free Digital Transfer. Report of a Case of Transfer of a Great Toe to Replace an Amputated Thumb. J Bone Joint Surg Br. 1969;51;4:677-679.
- Chen ZW, Bao YS. Microsurgery in China. Clin Plast Surg. 1980;7;4:437-474.
- Akchurin RS. Rekonstruktivnaya Mikrokhirurgiya Bespaloy Kisti = Reconstructive Microsurgery of the Fingerless Hand. Extended Abstract of Doctor’s Thesis (Med.). Moscow Publ., 1984. 26 p. (In Russ.).
- Borovikov AM. Mikrokhirurgicheskaya Autotransplantatsiya v Lechenii Povrezhdeniy Verkhney Konechnosti = Microsurgical Autotransplantation in the Treatment of Upper Limb Injuries. Extended Abstract of Doctor’s Thesis (Med.). Moscow Publ., 1991. 47 p. (In Russ.).
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