Background. At present, there are multiple approaches to the treatment of macrodactylia in children. Additionally, there are no comparative data on the cosmetic and functional aspects of corrective surgery versus microsurgical transplantations performed in children with a marked disproportion of the segment, making this study particularly relevant. Aim. The aim of this study was to determine the role of microsurgical transplantation of the toes in the treatment of children with isolated macrodactylia, based on a comparative analysis of various surgical interventions. Materials and methods. Twenty-five children with congenital macrodactylia of the hand were examined and surgically treated in the department of reconstructive microsurgery from 2013 to 2017. Of these, 13 (52%) had macrodactyly of the 2nd and/or 3rd fingers, and of the total number of hyperplastic hand segments (n = 45), 17 rays had hyperplasia greater than 25%. Results and discussion. Stage-by-stage modeling resections of enlarged segments were performed in all children with ray hyperplasia that was about 25% of the size of intact fingers. In 4 cases, excision of soft tissues was combined with marginal resection of phalanges. When hyperplasia of the segment reached up to 10% of macrodactylia, single isolated modeling resection of soft tissues and bones was performed. Repeated modeling plasties in 16% (n = 4) of the children were accompanied by gross postoperative scars with the development of secondary angular deformities and loss of function of interphalangeal joints. Nine children (n = 14) underwent amputation of hyperplastic fingers followed by microsurgical reconstruction of rays by autografting of toes. In 4 cases, the first finger was reconstructed, and in the other 5 cases, toes of both feet were transplanted to the positions 2 and 3 (n = 4) or 3 and 4 of fingers (n = 1). It was found that in cases of significant hyperplasia of the affected segments of the hand (hyperplastic segment is 1.5–2 times greater compared to normal ones), microsurgical autografting of toes is more effective and acceptable compared to bone and soft tissue resections. Conclusions. In cases of segment hyperplasia less than 1.25-times the normal size, the optimal surgical interventions are stage-by-stage modeling resections. An alternative surgical treatment for children with hyperplasia of more than 1.25-times the normal size is microsurgical transplantation of the toes in the position of the involved rays of the hand, which results in good cosmetic and functional outcomes in these patients.
A. Govorov 4Moscow state university of geodesy and cartography (MIIGAiK), Moscow, Russian Federation, 105064 The stereo matching is the key stage in determine an object's metrical properties on a stereopair which is taken with the help of stereoscopic technical vision systems. One way to find the corresponding points on the digital images lies in carrying the visual stereoscopic measurements by means of the specific software and hardware systems. The large majority of such solutions in the market are focused on the professional users with the experience in the stereophotogrammetric measurements. The outstanding feature of those software systems is the usage of the expensive hardware (professional graphic cards and monitors) with the aim of providing the capability of carrying the visual stereoscopic measurements. These requirements are not always acceptable (first of all due to their high price and high barrier of entry for an user) in the scientific space research, especially in the performance of the tasks that are not connected with processing of the remote sensing data. At the same time recently in the market appeared the value for money hardware solutions for stereo visualization based on the page-flip method of views separation. The results of developing the software for carrying the visual stereoscopic measurements based on one of the most popular solutions in game industry NVIDIA 3D Vision Kit for the user segment graphic cards (graphic processor GeForce) are presented in the paper.
Ключевые слова: стенозирующий лигаментит пальцев кисти, хирургическое лечение, дети.
Полидактилия является редким врожденным пороком развития, характеризующимся увеличением ко-личества сегментов луча кисти. Центральная полидактилия встречается гораздо реже, чем другие типы полидактилии, и характеризуется удвоением сегментов второго, третьего и четвертого пальцев кисти. Основные методы оперативного лечения центральной полидактилии заключаются в резекции дополни-тельных сегментов и устранении имеющегося сращения. Нередко результатом такого лечения является развитие вторичных деформаций, приводящих к неудовлетворительным результатам. В статье рассмотрен клинический пример микрохирургической реконструкции кисти пациентки с центральной полидактилией обеих кистей и продемонстрирован отдаленный результат.Ключевые слова: полидактилия, синполидактилия, центральная полидактилия, удвоение луча кисти, ми-крохирургия.
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