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Articole originale Jurnalul de Chirurgie, Iaşi, 2011, Vol. 7, Nr. 3 [ISSN 1584 – 9341] 22. Amitrano L, Guardascione MA, Brancaccio V, Margaglione M, Manguso F, Iannaccone L, Grandone E, Balzano A. Risk factors and clinical presentation of portal vein trombosis in patients with liver cirrosis. J Hepatol. 2004; 40(5): 736-741. 23. Miyakawa K, Tarao K, Ohshige K, Morinaga S, Ohkawa S, Okamoto N, Shibuya A, Adachi S, Miura Y, Fujiyama S, Miyase S, Tomita K. High serum alanine aminotransferase levels for the first three successive year can predict very high incidence of hepatocellular carcinoma in patients with Child Stage A HCV-associated liver cirrhosis. Scand J Gastroenterol 2009; 44(11): 1340–1348. 24. Tarao K, Rino Y, Ohkawa S, Tamai S, Miyakawa K, Takakura H, Endo O, Yoshitsugu M, Watanabe N, Matsuzaki S. Close association between high serum alanine aminotransferase levels and multicentric hepatocarcinogenesis in patients with hepatitis C virus-associated cirrhosis. Cancer 2002; 94(6): 1787–1795. 25. Salgado Ordóñez F, Gavilán Carrasco JC, Bermúdez Recio FJ, Rivera Jiménez A, González Santos P, Fuentes López T. Incidence and natural history of hepatocellular carcinoma in patients with chronic hepatitis C virus infection. Rev Clin Esp. 2000; 200(7): 360-366. 26. Weber A, Kbrebs S, Lenhardt C. Correlation of routinely used coagulation parameters and presence of portal vein thrombosis in patients with liver cirrhosis. Hepatol Res. 2009; 39(9): 882-887. 27. Zhang D, Hao J, Zang N. Protein C and D-dimer are related to portal vein thrombosis in patients with liver cirrhosis. J Gastroenterol Hepatol. 2010; 25(1): 116-121. 28. Landolfi R, Gasbarrini A. Thrombotic risk factors in patients with liver cirrhosis: Correlation with MELD scoring system and portal vein thrombosis development. J Hepatol. 2009; 51(4): 682-689. 29. Sharma P, Sharma BC, Puri V, Sarin SK. Natural history of minimal hepatic encephalopathy in patients with extrahepatic portal vein obstruction. Am J Gastroenterol. 2009; 104(4): 885-890. 30. Ahboucha S, Pomier-Layrargues G, Butterworth RF. Increased brain concentrations of endogenous (non-benzodiazepine) GABA-A receptor ligands in human hepatic encephalopathy. Metab Brain Dis. 2004; 19: 241-251. 31. Francoz C, Belghiti J, Vilgrain V, Sommacale D, Paradis V, Condat B, Denninger MH, Sauvanet A, Valla D, Durand F. Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation. Gut. 2005; 54(5): 691-697. 32. Connolly GC, Chen R, Hyrien O, Mantry P, Bozorgzadeh A, Abt P, Khorana AA. Incidence, risk factors and consequences of portal vein and systemic thromboses in hepatocellular carcinoma. Thromb Res. 2008; 122(3): 299-306. 33. Ögren M, Bergqvist D, Björck M, Acosta S, Eriksson H, Sternby NH. Portal vein thrombosis: Prevalence, patient characteristics and lifetime risk: A population study based on 23796 consecutive autopsies. World J Gastroenterol 2006; 12(13): 2115-2119. 34. Popa M, Vasilescu C. Minimally invasive splenectomy for thrombocytopenia associated with liver cirrhosis. Chirurgia 2010; 105(1): 15-20. 35. Kinjo N ,Kawanaka H, Akahoshi T. Risk factors for portal venous thrombosis after splenectomy in patients with cirrhosis and portal hypertension. Br J Surg. 2010; 97(6): 910-916. 36. Krauth MT, Lechner K, Neugebauer EAM, Pabinger I. The postoperative splenic/portal vein thrombosis after splenectomy and its prevention – an unresolved issue. Haematologica 2008; 10: 3324. 37. Ciocirlan ME, Ciocirlan M, Diculescu MM. Portal vein thrombosis in hepatocellular carcinoma. How can we predict it? Maedica – a Journal of Clinical Medicine 2006; 1(2): 5-10. 38. Plessier A, Darwish Murad S, Hernandez-Guerra M, Consigny Y, Fabris F, Heller J, et al. A prospective multicentric follow-up study on 105 patients with acute portal vein thrombosis (PVT): Results from the European network for vascular disorders of the liver (en-vie). Hepatology. 2007; 46: 310A. 407
Articole originale Jurnalul de Chirurgie, Iaşi, 2011, Vol. 7, Nr. 3 [ISSN 1584 – 9341] PARTICULARITĂŢI ALE REEDUCĂRII FUNCŢIONALE A TENDOANELOR FLEXOARE ALE MÂINII. ANALIZA UNUI LOT DE 112 CAZURI. I. Ţopa*, T. Stamate * doctorand Universitatea de Medicină şi Farmacie „Gr.T.Popa” Iaşi Clinica de Chirurgie Plastică, Reconstructivă şi Arşi Universitatea de Medicină şi Farmacie „Gr.T.Popa” Iaşi FUNCTIONAL REEDUCATION SPECIAL FEATURES OF HAND FLEXOR TENDONS. ANALYSIS OF 112 PATIENTS (ABSTRACT): Functional reeducation in "no man's land" areas represents a challenge for the hand therapist, the large number of therapeutically protocols with the comparable results pose questions about how to understand, to choose and to apply theme. This variation guides us to combine some protocols for find the best solution in tendinous lesions without associated injury (nerve, vessel, bone). Methods: This study compare the functional results between Kleinert, Silfverkiöld-May, Gratton protocols associated with tenodesis movements (Cooney protocol) and Strickland protocol towards evaluate them by interconnection and with the literature. The patients were evaluated regarding TAM, grip strength, finger dexterity and disability in daily living activities at 8 weeks postoperative. Results: We studied 112 patients consecutives and who not suffered tendons ruptures and found the best results to Strickland group followed by Silfverkiöld and May, Gratton and Kleinert groups. Conclusion: For the lesions tendinous injury in zone II, our first is to use the therapeutically indication Strickland protocol. KEY WORDS: FUNCTIONAL REEDUCATION, FLEXOR TENDONS, ZONE II, TENDON LESIONS. Corespondenţă : Dr. Ionuţ Ţopa, Spitalul Clinic de Urgenţe ‚,Sf. Spiridon” – secţía exterioară Copou, Str. Gen. Berthelot, nr.2, Iaşi, e-mail: ionuttopa@yahoo.com * . INTRODUCERE Zona II a tendoanelor flexoare ridică probleme dificile din punctul de vedere al obţinerii unui rezultat funcţional optim. În lipsa aplicării unui protocol adecvat de reeducare precoce, cicatrizarea extrinsecă a tendoanelor flexoare va conduce către formarea de aderenţe şi blocarea tendonului în canalul osteofibros digital. Numărul mare de protocoale din literatură pune terapeutul într-o postură dificilă de alegere şi utilizare a lor. Acest studiu îşi propune să compare rezultatele aplicării a 4 protocoale terapeutice, încercând să facă o evaluare completă a pacienţilor privind rezultatele după TAM (Totale Active Motion), dinamometrul Jamar, bilanţul de 100 de puncte (reintegrarea în activităţile socioprofesionale) şi Minnesota Turning Test (dexteritate). Ierarhizarea protocoalelor terapeutice după rezultatele funcţionale poate conduce către obţinerea unui ghid de utilizare a lor. * received date: 12.03.2011 accepted date: 26.06.2011 408
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