Današnje mogućnosti rekonstrukcije palca šake

master's thesis

• Title (english): Contemporary possibilities of thumb reconstruction
• Author: Tea Andrović Knežević
• 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: 2015-01-30, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Ljudska šaka jedno je od najupečatljivijih obilježja čovjeka koja ga čine drugačijim od životinja, a tu razliku i djelotvornost čine karakteristike ljudskog palca. Palac je drugačiji od ostalih prstiju po svojem položaju, što ima 2 a ne 3 falange, od kojih je distalna šira od proksimalne, a pripadajuća metakarpalna kost mobilnija je od drugih. Dok je kod ostalih prstiju najbitnija pokretnost, za karakterističnost funkcije palca zaslužni su stabilnost, dužina palca i oponirajući položaj. Zbog posebnosti palca, u slučaju njegovog manjka ili oštećenja kompromitirane su sve radnje ljudske šake, pa i cijele ruke. Jasno je zašto je bitno rekonstruirati palac, čak i ako dođe do gubitka nekog drugog prsta. Pri planiranju operacije uzima se u obzir veliki broj čimbenika – razina na kojoj je oštećenje nastalo (u slučaju traume) ili do koje su strukture nerazvijene (u slučaju prirođenog manjka), stanju ostatka ruke, muskulature tenara, i o samom pacijentu - njegovoj dobi, zanimanju, sveukupnom zdravlju i zahtjevima. U skoro stoljetnoj povijesti pokušaja što bolje rekonstrukcije, opisane su i isprobane brojne metode, a u ovom radu osvrnut ću se na one koje su u uporabi danas. Tehnike uključuju replantaciju amputiranog palca, različite režnjeve, zamjenu palca drugim prstom (nožnim palcem, 2. prstom ruke) i osteoplastiku. Varijacije u tehnici vode do različitih ishoda, čineći pojedine pogodnijim za različita oštećenja.

Abstract (english)

The human hand is one of the most distinct features that differentiate human from animal, and its difference and efficacy comes from charasteristics of the thumb. The thumb is different from other fingers by its position, having 2 phallanges rather then 3, where the distal one is thicker than the proximal, and the associated metacarpal bone is more mobile than the others. While the most important attribute in other fingers is their mobility, thumb's charasteristic function is due to its stability, length and opposition. Because of these specific characteristics of the thumb, in case of maldevelopement, damage or loss of the thumb, all the human hand's actions are compromised. The importance of thumb reconstruction is clear, even if it means losing some other finger. During planning of the operation many factors are taken in count - the level of damage (in case of trauma) or undeveloped structures (if congenital defect), state of the rest of the hand, of the thenar muscles, and the patient himself - patient's age, proffesion, overall health and requests. In nearly hundred years of striving to achieve the best reconstruction, many methods are described and tried, and this paper will overview ones being used today. Methods include replantation of the amputated thumb, a number of flaps, substitution of thumb with another finger and osteoplastics. Variations in technique lead to different results, making each one more suitable for different defects.

• Keywords: palac; rekonstrukcija; trauma; kongenitalne anomalije
• Keywords (english): thumb; reconstruction; trauma; congenital anomalies
• Language: croatian
• URN:NBN: urn:nbn:hr:105:538354
• 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: 2016-03-29 09:19:32