THE ANALYSIS OF MORPHOFUNCTIONAL CONDITION OF THE UPPER LIMB MUSCLES IN TREATMENT OF PATIENTS WITH POSTTRAUMATIC ELBOW FLEXION-AND-EXTENSION CONTRACTURES

The aim of the work was to study the echography visualization-based structural features of muscles and the wrist radial flexors for surgical treatment of 56 patients with the elbow flexion-and-extension contractures. The result of surgical treatment in the main group of patients consisted in the increase of the elbow extension angle. Muscle pattern was similar to a typical, normal ultrasound image. The most characteristic feature was a significant decrease in the muscle belly thickness. The thickness of fore-arm flexor muscular layer was 29,2% decreased for the brachium injured amounting to 16.5 ± 4.7 mm (P ≤ 0.05), and that for the intact segment - to 23.3 ± 2.6 mm. In the immediate periods after treatment the signs of atrophy remained. It manifested by the significant decrease of the anterior muscle group thickness with regard to the intact segment values. The index of the echo intensity of m. biceps brachii in operated limb increased by 53.7% compared to preoperative values, reaching 22.8 ± 2.1 conv. u (P <0.05), and m. brachialis - 30 conv. u (P> 0.05). Before the treatment in patients aged 8-13 years the relative strength of the forearm muscles was reduced by 12% compared with those on the contralateral limb (P <0.05) according to t-test, and in the older age group - 20.9% (P <0.01). With increasing of movement range in the late periods after treatment were observed satisfactory contractile response of the upper limb muscles. At different stages of reconstructive and restorative treatment of patients with posttraumatic elbow contractures it is advisable to use a combination of ultrasonic imaging of muscles and hand dynamometry with the definition of the relative strength of the muscles.

эхография, мышцы верхней конечности, локтевой сустав, посттравматическая контрактура, метод Илизарова, сила мышц, upper limb muscles, elbow posttraumatic contracture, echography, dynamometry, Ilizarov method, surgical treatment