Rekonstrukcije složenih ozljeda šake

master's thesis

• Title (english): Reconstruction of complex hand injuries
• Author: Sara Abbaci
• Mentor: Rado Žic (mentor)
• Committee member: Srećko Budi (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Rado Žic (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Anatomy

Abstract

Šaka je dio tijela kojim se čovjek služi od početka do kraja svog životnog vijeka, svakodnevno i u velikoj mjeri. Narušavanje njena integriteta ili bilo kojeg dijela šake rezultira invalidnošću i velikim otegotnim okolnostima u svakodnevnom profesionalnom i privatnom životu. Zbog kompleksnosti funkcija koje šaka izvodi, njena je anatomija kompleksna te se ona dijeli na prednju stranu, dlan, hrbat i prste.
Do složenih ozljeda šake često dolazi u prometnim i nesrećama druge vrste te na radnom mjestu. Koji god bio mehanizam ozljede, ozljeda šake zahtijeva detaljan pregled i uzimanje anamneze. Nakon pregleda slijedi slikovna dijagnostika koja pomaže kirurgu da u suradnji s pacijentom napravi plan rekonstrukcije koji će najviše odgovarati pacijentovim potrebama. Na početku same operacije mora se ukloniti devitalizirano tkivo. To se čini od ruba rane prema unutrašnjosti. Za razliku od debridmana, s rekonstrukcijom se započinje od unutrašnjosti, najčešće stabilizacijom koštanih struktura, a nakon toga se kreće na rekonstrukciju mekih tkiva. Posljednji, ali ne i manje bitan segment brige za pacijenta koji je pretrpio ozljedu šake jest rehabilitacija. Nakon operacije je potrebno što prije i u što većoj mjeri vratiti funkciju šake. To se postiže imobilizacijom, koja je najkonzervativnija metoda rehabilitacije, no obično neophodna. Nastoji se što ranije započeti s pasivnim i aktivnim kretnjama kako ne bi došlo do stvaranja kontraktura i smanjivanja opsega pokreta.

Abstract (english)

A hand is a part of a person's body which he uses from the very beginning to the end of his life, every day and a lot. Disturbance of it's integrity or integrity of any of it's parts results in disability and significantly harder functioning in professional and private life. Due to the complexity of hand's functions, it's anatomy is also complex and the hand is divided into front side, palm, back side and fingers.
Complex hand injuries usually occur during car accidents or accidents of some other kind and as a result of workplace accidents. No matter the injury mechanism, hand injury always demands detailed examination and history. After the examination, imaging methods are in order which are supposed to help the surgeon to make a reconstruction plan in collaboration with a patient so that the plan suits patient's needs. At the beginning of the operation surgeon has to remove devitalized tissue. That is done from outside of the wound to the inside. Unlike debridement, reconstruction is started from the inside, most commonly by stabilizing bone structures and after that the reconstruction of soft tissue starts. Last, but not less important segment of hand injury patient care is rehabilitation. After the operation it is necessary to restore hand function as good and as fast as possible. That is accomplished by immobilization, the most conservative but usually inevitable rehabilitation method. They aspire to start passive and active movements to prevent contractures and reducing movement range.

• Keywords: šaka; rekonstrukcija; režnjevi; rehabilitacija
• Keywords (english): hand; reconstruction; flaps; rehabilitation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:320800
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-11-18 10:11:00