K_stkovy panarits_y. Panaritium on the fingers, lykuvannya likami and surgical

- the price of firing cyst structures of the finger. May be the first (rіdshe) or the second. The primary pathology manifests itself in an intensely smoother and more significant hyperthermia in some cases, in a large amount and in intermittent ruffles, which appear through a few days of the process of finger injuries during Secondary cystic panaritus develops as a result of widening infections with other forms of illness, superficial fever and trivial suppuration. Diagnose at a glance, radiography, laboratory dosages... Lіkuvannya operatively - roztin, curettage, cystkova resection. With a significant ruptured cyst, amputation is indicated.

ICD-10

M86 osteomyelitis

Country houses

Cystkovy panaritsiy - rizvid fierce fire finger tissue from cyst lesions (osteomyelitis). It is often possible to develop pathological conditions, due to the growing data, to become from 37 to 60% in the outer structures of the igneous-ignition processes in the area of the fingers of the hand. The primary osteomyelitis of the phalanx appears in all 5-10% of the ailments, in the case of patients, the patients are encouraged to secondarily ignite the brush. The overwhelming majority of vipads (close to 80%) have a nigty phalanx. It is often the case that they come to the fore-workers of virobnists with an increase in the number of injuries and intensive obstruction of the hands with aggressive words - among the tractor drivers, slyusars, vantage workers, and other people. Pathology can be diagnosed in all groups of patients, depending on the disease of the middle age.

cause

A non-mediated cause of cystic panaritism is a pediatric bacterium, an affliction is staphylococci, earlier associations with other microorganisms, a synogniina stick, kishkova palichkaі coccal flora (enterococci, streptococci). The primary form develops in case of hematogenous drift of infection from long-range gnarial cavities and in case of paraossal hematomas. The reasons for the secondary process are:

pidshkirny panaritsiy... To develop in a number of diseases, which is associated with a rotated local toxicity, important damage to the muscular blood circulation, which occurs when the cells of the fingers are burnt to the cyst. Most often it is hostile to the distal phalanx.
Tendon and suglobovy panaritium... To be seen in the anamnesis before the pedagogical panaritia. Call the front to melt the cob and middle phalanges.
Інші form panaritsіyu... In the vicinity of the osteomyelitis of the distal phalanx, it appears in case of paronychia, periungual panaritism, and the protections form a small part in the structure of congestion.

Through the high degree of development of cystic panaritics, when there is a growing form of ailment, in special literature, orders are made for those who, with suppurative cells, are seen to look like two or more Factors up to the gross reduction of the hand in any ethology process are involved endocrine discomfiture, Decrease, decrease in immunity of a child's genesis (in case of maladies, maladies, in cases of hormonal problems), changes in problems, trophic and microcirculatory cold damage, in cases of

pathogenesis

In case of hematogenous enlarged infections, pyogenic microbes penetrate into the cyst's speech through the life of the judge. Okustya and mozkovu speech will ignite, in knitted fabric sequestry is formed. In case of secondary pathology, the burning of soft tissues expands to the periphery. The development of the pathological process is affected by the pathological and physiological mind, especially when the soft tissue structures are inflamed in the distal phalanges, the winter is a small amount of tissue, which is a sense of the formation of the strained heat of the localized inflammation.

Especially the osteomyelitis of the phalanges of the fingers є the strength up to a large-scale ruining of the skin. In case of osteomyelitis of the localization of the area, it reacts to the firing of the so-called "cyst box", which will prevent the possibility of a second renewal of the cyst structures to be found in the case of significant rupture. When the process is in the area of the phalanges, it does not appear, it necrotizes quickly, and the regeneration of the old young can only be seen in the sequestration. With a significant melted solution of the window, there is a lack of evidence for the renewal and coverage of a new brush. We will explain the low efficiency of the process and the need for amputations in a trivial or voluminous ignition process.

Classification

From urahuvannyam ethiology razryznyayut first (vinik on aphids or hematogenous) and second (contact with other types of ailments) cystic panarits. Oskilki osteomyelitis is hostile to the distal phalanges, the classification has been broken up, and it is allowed to initiate the tactics of treatment for this particular pathology. There are three types of cyst structures:

Craiovy or late sequestration... Ruinuvannya of the brush is of a small local character, the oxide is slightly melted, possibly outside the renewal of the brush. With the presence of marginal sequestration, the collapse of the finger can be lost. With late sequestration, a distal finger joint is formed before the process, as a result of old ankylosis.
Sequestration for saving the phalanx... Gnіyny process is localized in food delivery of the brush, epіphіz not changes. Nezalezhno bloodstatic epiphyseal and diaphyseal zones of the brush will be safe with a friendly mind for renewal with sufficient savings. The decision about saving or amputation of the finger is taken individually with regard to the size of sequestration and triviality.
Phalanx sequestration... The change of the brush from the sides is chipped with empty, filled with gnome. The suppuration expands to the joint and the tendon. Outside is zruynovana in order to save some small dilyanki, not old until re-regeneration. Amputation is required.

Symptoms of cystic panaritus

In case of secondary lesions, you suffer from distal phalanges of I, II and III fingers. A class of spontaneous behavior is characterized by a typical picture of a pediatric panaritism, which is supervised by a local swelling, hyperemia, pulsating pain along the long-lasting surface of the finger, weakness, rosbitism, temperament. Then, in the urazheniye region, it is possible to establish itself in the fire of suppuration, which is self-sustaining to open up on the cradle, or to be drained by a gnarly surgeon, the mischievous and remote signs of burning change. The enlargement of pus on the cyst structures is manifested by repeated improvements in symptoms, yak at the cob stages of osteomyelitis, however, not reaching the degree of turn, characteristic of pediatric panaritism.

At the first rate of panarits, gostro is developed. Phalanx nabryakaє, shkіra chervonіє, and then an increase of crimson-cyanotic, vinyayut intensively relieve pain. The finger is in the position of being impaired, active and passive, to overcome the pain syndrome. The zagalny hyperthermia is significant, the temperature is only 40˚C, and there may be chills. With the progression of the primary and secondary process, a bulbous extension of the finger appears. Shkіra on the urazhenіy phalanx is loaded, smooth, blisky. A phalanx of a sore throat. Dilianki is set to necrosis. Fistulas form, start roztashovani in the subungual zone. There can be a deformation, knitted with ruinous soft tissue and cyst structures.

accelerating

In case of deterioration of immunity, improper or unfortunate lykuvanni cystovy panaritium can turn into pandactylitis - burning all tissues of the finger, including the loam and tendon. In some cases, the process expands proximally. There may be phlegmon of the brush, phlegmon before the disease, gnar arthritis of the wrist. In important cases, sepsis develops, which is a threat to the life of the patient. As a result, contractures, stiffness or ankylosis, severe cicatrices, lesions of loose tendons and loops, and trivial immobilization are uncommon.

diagnostics

Diagnosis is diagnosed by faults in the area of gross surgery in case of a patient's malignancy in a polyclinic, earlier - in case of an extraordinary hospitalization in connection with the swelling of a grievous process. In the process of diagnostics, a characteristic anamnesis is obtained, a typical clinical picture of a fallacy and a history of pre-daddies. The planning plan includes steps in:

Opituvannya, look around... In the primary process, a finger injury appears in the anamnesis, or the presence of a distant gnarly head. With a second option, it will arise that ailments stretch out in front of the two or more cases of suffering in the form of panaritism. When you look around, you will see a bulge, a fistula and a fistula with gnarly visions. With a careful introduction of the probe, the surface of the brush is visible.
radiography... Radiological acquaintance with the ill-education of the phalanx, with reactive osteoporosis, due to the abrasion of the contours, in the case of contour formation and destruction. In some cases, when the cyst is heated, the finger may not be visible on the roentgenogram, but it can be pompous, such as necrosis. In case of necrosis of the cyst, it is possible to see a sequestration on it, which can change in an hour. When a slope is formed, a slope of a slope makes a sound, the articulating surfaces of the cysts become irregular.
laboratory analyzes... Gnіyne zapalennya supervising characteristic laboratory changes: the development of SHEE, leukocytosis due to hypotension, rheumatoid factor in the blood, C-reactive protein and antistreptolysin-O. Seeding an early warning about the manifestation of pyogenic microfloria, allowing the visibility of sensitivity to antibiotics.

Lіkuvannya kіstkovy panaritsіyu

Lіkuvannya tіlki hіrurgіchne. It is easy to choose from the urahuvannya of fistula growth and given by roentgenographers, primed on the principles of maximum preservation of functions and the working surface of the finger. Call the roztin panaritium zd_ysnyuit by the way of the expansion of the noritsa go. Vidalennyu p_dlyagayut yak k_stkovі sequestry, so і wasted otochuyucha klіtkovina. The vividness of non-published dalyanoks has its own peculiarity, tied with a small amount of fabrics in a given zone. When hanging the clinker, do not pick up the scalpel, but for the snake knives, change the little parts of the mosquito, pull on oneself and the dilenka for the dilenka, carefully use the gazing knives.

We start to get started before the uzhazhennaya kistki, as it also can be borderline economical. There is a bit of sequestration in the bed. Okremo roztasovany health dilyanka, as they have saved contact with the periosteum, lishayut navit with an unassigned prognosis їх renewal. The wound is washed out with a tight jet of a hypertonic tube from the syringe. In the common place there are dressings, antibiotic therapy will be added to the antibiotics introduced at the storehouse.

When there are no prospects for renewal of the phalanx, the threat of a further enlargement of infection is violated by amputation, or by the exarticulation of the finger of the hand. When taking the decision about the amputation of the first finger, it is more functional, if possible, it is possible to save the skin milimeter, if there is a threat of deformity and ankylosis, some deformities of the puppet toe, and often With a significant decrease in the number of fingers, the level of amputation is vibrated in such a way as to create a functional cicatrix from the outer cicatrix to the working surface.

Forecast and prevention

The prognosis of cystic panaritism will begin with the broadening of the osteomyelitic process, with the sparing of the surrounding structures and with the level of recovery of the surrounding structures. With a quick liquefaction of edge sequestration, the result will become more agreeable. In some cases, at a given period, it is possible to speed up and / or damage to the collapse of the finger, cicatricial deformity. Prevention of polygens in case of transient and lateral injuries, pancreatic injuries (mitt) with robots with drastic talk, which are immediately turned to a doctor-surgeon in case of such early injuries of the fingers, adequate

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- tse osteomyelitis of the phalanx. In the last ten years, the number of accelerated forms is decreasing, and even in the middle of the cyst panarits, they are thrown into the first place.

In the blood-posture of the hand, they take on the fate of all the arteries of the hand, setting up a thick net with a mass of anastomoses, not only in soft tissues, but in the skeleton. In the distal phalanx, there is an additional arterial artery (Fig. 21), which will prevent the epiphysis of the phalanx from becoming infectious and capable of regeneration.

Fallow od Budova phalanx od vіrulentnostі іnfektsії, od holding lіkuvannya i will Zdorov'ya patsієnta osteomієlіtom urazhaєtsya abo Chastina phalanx (obmezheny krayovoї osteomієlіt) abo entire dіafіz (dіafіzarny osteomієlіt) abo protses zahoplyuє entire phalanx (total osteomієlіt).

Cystkovy panaritism is a hematogenous osteomyelitis and a primary midsection is spontaneously fast (in 5-10%). In a large number of ailments (90-95%), the process is in the wines of the vineyard, such as the accelerated burning in soft fabrics (E.V. Usoltseva, 1970).

The first cyst panaritus is displayed on the display of growing muscle signs of fieryness, which is localized in the phalanx of the finger. Tse - bezperervny bіl, to develop in glybinі - in kistki; Vona snake trim your finger in the snug position, take care of your hand from rukhiv, dots.

Small. 22. Osteomyelitis of the diaphysis of the middle phalanx of the forefinger in the sequestration phase (schematic baby with roentgenograms).
a - before the operation; 6 - writing sequestrotomy; c - the result of the treatment in 4 ms.

The price is the tension of the soft tissues of the finger. If there is a reason for the appearance and swelling, zagalne nezduzhannya, Inodі with adjustments of the temperature of thіla.

When the phalanges of the button-shaped phalanxes are reached with a probe, start sharp bile from strong and hollow side.

The second cyst panarition will be presented at the post of an accelerated panarition of soft fabrics. A clichéd picture in most ailments develops on the aphids of an operable pediatric panaritium of the distal phalanx. After a few days of polishing the zagalny camp, the calming down of the pain and the change in the size of the picture, the picture was taken. There is a pulsating beat, swelling, harshness; the tip of the finger is flask-shaped, swollen, growing hot, the thickening of the fingers is rigid, the ruffs are enclosed and the pain is, the backward camp and the self-respect of the ailing one will again be lost. Such a picture is indicative of those that panaritsi slowed down, infections expand into the world. It is necessary to locate, de von: in the knuckles, in the slopes, in the tendon, or the process has expanded on all tissue of the finger.

Symptoms are assigned to the patient before allowing to suspect the presence of cystic panaritus as the most frequent type of acceleration. Suglobovy and tendinous panaritus are affected by the nature and localization of pain (with obtuse puffy probe), by the wideness of the swelling and deterioration of the function. Radiological advances in the first 7-10 days do not give overwhelming tribute, so as destructive changes in the handset appear in 10-15 days and serve as the same confirmation and clarification of the clinical report.

There are three stages in the radiological picture of the cyst panarice. The first is manifested by plyamistic osteoporosis, the friend - by periosteal reaction, the third - by the destruction of the cyst, and by the approved sequestration. At the same time, the cistka’s dilenke doesn’t loosely stretch out for a trivial hour, zberigє links with lively fabrics, and sometimes it’s blotted out without sequestration, or take part in the regeneration. Before a wounds with a button-like probe can be detected, the appearance of a bare cyst is not reliable, especially on the distal phalanx.

The development of cyst panaritics in 3-4 months, in the phase of sequestration, does not become difficult. The phalanx was damaged to become flask-like, swollen, є fistulas with gnarly images, and on the roentgenogram the destruction of the cyst was noted, in some cases and in the appearance of sequestration. Cystkovy panaritism of middle and proximal phalanges and pyastoid cysts is more similar to the clinical and radiological picture of osteomyelitis of some tubular cysts.

Lіkuvannya kіstkovy panaritsіyu. It will be shown that the infection of the cyst was earlier recognized and the phalanx was distally damaged, so there are more chances for recovery without additional surgery. Dealing with cyst panaritism of the distal phalanx to fix the problem of the sick, finding the cause of the delayed interruption, assessing the forehand and the plan of further calls.

Repeated operations on the hand are rotated in a planned manner, according to the basic operative surgeon, and when there are visible minds for engaging.

Before the operative osteomyelitis, not only the preparation of the school is carried out, but also antibiotic therapy, since it did not overwhelm it. Having acquired the microflora and sensitivity to antibiotics, it is possible to develop a regular internal infusion of antibiotics with prolonged deposits in the middle of the damage. Deafness non-lining bandage is also used for interfacing the process.

Our admittance showed that a third (30.4%) of the sick were more likely to cleanse their children and wounds and the need for repeated operations. The ignition process is regressing - entering other sequesters, wounds are cleansed and burned.

Introduce properly complex conservative approaches і antibiotics, vikoristovuchi їх in іх variants, we still will not overshadow them. Even though it was not the instruction of an obvious polypshenny (change in pain, nagging, vision), it is not meant to renew the decay of the connection, the pangs of the ailing one were crimped by the hand, and during the X-ray there was a sequestration - the operation was closed.

To assess the results of conservative therapy and for the preparation of a sick person, finish in the middle 5-7 days. In 85 out of 125, we had ailments, the process in the brush did not appear, and the stench was re-operated.

The operation is carried out during the provincial, intraosseous or internal anesthesia and in the blood, in the case of anesthesia.

Growth to be robbed of fallowness due to the localization of the ignition process from Svishchev's vikorystannya runs and to the front of the operative wounds. M'yak_ fabrics with a scalpel tilt up to the brush, razsuvayutsya with knobs and look around. I At all, you can study різні options process:

1. Razr_zom rozkritii gn_yny kishenyu in soft tissues, the tuberosity of the distal phalanx is revealed. The navkolishn_ fabrics should lie down to the brush. In such a way, necrotic m'yak_ fabric... The wound is washed out with furacilinu. Golu dilyanka of tuberosity is primed with soft fabrics. The edges of the wound are approached by an aseptic Leukoplastic bandage. Immobilization.

2. Razrіzom rozkritiy gnіyny vognische in soft fabrics and appearances of denudation, deformations of crumbling deformations of the tuberosity of the distal phalanx. The hanging of necrotic tissue is carried out and the bottle is sequestered by the brush with gusting knives or nippers from the manicure set. The wound is washed with furacilin, a hemostatic sponge is laid; the edge is approached with an aseptic bandage; immobilization.

3. The granule wound is enlarged by the growth, and in the absence of cysts of sequestration, and the nodular tuberosity of the distal phalanx is porous. Carried out chastkov abo povna resection tuberosity. Completely when using a special brush retractor, and a brush with a diamond disc of a drill; sawdust cleaned with a milling cutter. On the 7-8th day, after preparing the wound, apply second seams and the bunches of the correct shape. on great finger in individuals with a strongly developed tuberosity of the distal phalanx, after resection, the stitches are brought back to the formation of the scar, and sometimes recommend to the patient more plastic substitution of wadi.

4. The marginal osteomyelitis of the phalanx diaphysis is revealed. Hanging of necrotic soft tissues, fistulas is carried out, it is economically vidsharovoy, sysvaetsya okistia; with an oval chisel, or with a gusting spoon, you can see the dilenka of the basket. The edge of the cyst wound is watered, the brush is attached to the oysters, the wound is washed with an antiseptic, the edge is approached with an aseptic bandage. Immobilization.

5. Rozkrito gn_yny in the fire. In the glybin, one can see the bare sides, the shorts, the crumples and the sequesters. It is necessary to widen the wound, in order to develop an additional growth, so that you can look around the entire phalanx and see the damaged part, which can be damaged by the epiphysis, such as a dodatkovu artery, the distal interphalangeal loam. As soon as it penetrates into the loam (cyst-loam panaritium), arthrotomy is performed, it is seen as necrotic tissue, when empty it is washed with antibiotics or antiseptics, it doesn’t make it appear that it’s faint.

These are the main options pathological changes with cystic panaritus of the distal phalanx.

Apparently, in 20-25% of those with ailments we have experienced, the operation was interrupted by the weakening of the shortcomings in front of the front. At the same time, in the early days, there were swarms of overgrown pus, little necrotized clumps of pus, nothing, surplus gum from the drainage, clumps of "krikhti" and іnshі tila, and suppuration. When you looked around, you could see traces of an incomparable brushwork: the appearance of viboin, trishchin, appearance of the ovary, etc.

Zblizhennya edges of the wound can be reached with a second suture, Leukoplastyrna with a bandage, a non-lining gipsovo, or with Unna paste, a non-burdening bandage. Pislyaoperatsіyne lykuvannya illnesses are conducted according to the same principles.

S. A. Stupnikov (1974) direct offensive results lіkuvannya osteomієlіtu nіgtyovyh phalanges in gіrnikіv. In 1340, there was a preservation of the function renewal in the presence of phalanx deformities in 718 ailments, the function renewal with a phalanx defect - in 326, with a finger defect - in 153, with a hand defect and an amputation of the phalanx - 87 finger - in 9 individuals. The average triviality of the trip is 19.8 days.

Cystkovy panaritium of the middle and proximal phalanxes of the fingers of the hand develop significantly earlier, being accelerated to pediatric or tendon panaritism; as the primary form of vinikє rydko. The development of cyst panaritism of the middle and proximal phalanges and p'acpalate cysts is primed on quiet signs, as well as the distal phalanges. Klinichna picture i functional rozladi more bends.

Differentiation of osteomyelitis is required from pediatric, tendinous panaritus, phlegmon of the hand, from a specific lesion of the phalanges in tuberculosis, bruceliosis, syphilis and from pukhlin. Really take anamnesis, respectful of the sick person, and the radiological dosage allowance to be cleared up.

With the treatment of cystic panaritism of the middle, proximal phalanges and p'acular cysts, while the process in the cyst does not vary with different localization, the entire arsenal of abortive treatment will be used in conjunction with the imitation of antibiotic therapy.

Cystkovy panarits_y in the phase of gross melting down of operuvati. The operation is often atypical. Rose above the igniting vognische through the fistula or overwhelmed the operative wounds. M'yakі fabrics, loosely, nibbling fingers, nerves and tendon pіkhvy. If the oxy is bare, it’s not well hardened, but it’s not peeled off, it’s not a slid, shkrebti. Trepanation of the cyst is carried out in quiet areas, if the cortical ball is excreted, the fistula is or radiologically established osteomyelitis from the sequestral emptying. Too, it is necessary to open the bone marrow empty in the ear with a cone-like or grooved chisel on the floor, so that you will not be able to look around and the lining of the head. Then, with a spoon, you see granulation, sequestration, the wound is washed with furatsilin, the edge of the cyst wound is washed, smoothed, the empty is washed again, hung.

Small. 23. The result of osteomyelitis in the patient G.
a - deformation of the hand and III finger, interconnected function; b - scheme with radiographs - deformity of the proximal phalanx of the third finger, synostosis of the second and third carpal-metacarpal joints.

Only after having crossed over in a bitter sample, i.e., during the daytime in the cyst and in the soft tissues of the tissue for necrosis, granulation, other cystic ulcers, notches and aliens, Pinch the bloodstream and prevent hemostasis. The cyst's wound should be covered with an aponeurosis or with one or two sutures, or a hemostatic sponge should be laid. Shkira is cleansed from blood slides, dubbed with alcohol. Aseptic bandage to approach the edge of the wound. Hand lay in the back of the prepared gipsovu splint. Drainages and drains are not inserted into the wound if possible.

In case of an accelerated interruption, as a result of a loss, or a lack of radical involvement, a cyst panaritism will become important to important ailments, as a result of permanent treatment.

Pidsobny robin of the svinosovkhoz G., 53 years; I do not know the cause of the illness. Drobnі wounds, trenches, calluses of hands bore at a ny more often. Ten days ago, the third finger of the left hand appeared. In the district polyclinics of the hollow-bichny ones, there is a bladder of the pediatric panaritium of the proximal phalanx. The wound is tamponuvati. The process is not updated. Stretching out two types of UHF, one for the penicillin. Repeated operation: two bachelor razryzu, vyshkrіbannya spoon, draining wounds.

Small. 24. Spraying the tip of the first finger from the growth of nigtems and numerically retracted, tender scars on the osteomyelitis of the distal phalanx.

The first operation did not preserve sufficient purity of the cyst and the visualization of the process, the process progressed, slowed down by the subtle pyaponeurotic phlegmon, lymphangitis, osteoarthritis of the wrist joint. Hospitalization.

Operation with anesthesia. Trepanation and sequestrectomy of the proximal phalanx, rostin of paponeurotic phlegmon, immobilization. Trivale lіkuvannya antibiotics. Symptoms of an unbroken hand, polyphibrosis, stiffness of the joint, arthritis of the wrist-P'yastiv joint. Result - Invalidity of the II group by supremacy gallantry(Fig. 23).

Osteomyelitis, when the infection passes through the infection to the palate from the soft tissues, is prevented from slowing down the interfacial spaces or the phlegmon of the interfacial spaces. The form of an important infection of the Bula's hand is described by A. N. Rizhikh and L. G. Fishman (1938) iodine is called "panphlegmonia" ignition process I will grab all the fabrics of the brush. Radiologic obstezhennya in cych vypadki reveals osteoporosis of the skeleton of the hand, osteoperiostal lesion of one or more deciduous cysts, some with marginal or central sequesters. The process often leads to serous or severe arthritis of the wrist joints.

Three four-cyst panaritsia fall on the distal phalanx, in conjunction with the increased efficiency of the supply of food to preserve the bundles to the organ.

As a result of ill-conceived treatment of osteomyelitis of the distal phalanx, the phalanx is trivial and indulgent.

For example, P. ailment, 35 rocks, with osteomyelitis of the distal phalanx is small licorice leaf stretching 138 days, and then two rocky "mastered" the little finger of the first right hands, Deformations of food for chotiric operation and numerical infusions of antibiotics (Fig. 24).

Ten parts of cyst panaritsi are spontaneously placed on the proximal phalanx, both styles and fits on the middle phalanx and on the palms of the cysts at once. The greatest amount of cyst panaritsia is seen on the first finger (31.4%); trochas less (28.8%) - on the other; 20.3% - in the third; Significantly less on the fingers of the group: the fourth - 9.5%, the fifth -6.7%, and in 3.3% of the history of the disease, the localization of the disease was specified.

The importance of the majority of ailments on cystic panaritium (79.8%) was operative, and they were treated conservatively. The triviality of the trip varies from 10 to 44 days.

The folding of the cyst panaritism in the case of 7.8% of the ailments; character і frequency їх (in%) of guidance is lower:

Stiffness zelenuvan 16.6
Trophіchnі rozladi 10.1
Ailments with scarring 9.8
Folded by other types of infectious diseases 19.5
Combined acceleration 39.4
Інші 4.6

It seems to be vivid, but in the most important way there was a combination of accelerated, for example, the added dullness of the fingers from the tender cicatrices. Taste of a lack of osteomyelitis in the presence of a dermal sick person є an accelerated osteomyelitis with a lesser type of infectious disease.

At the same time, it’s not easy to get a second quicker (arthritis, phlegmon), but not all at once, but after being added, after a few days of robots.

M. I. Litkin і I. D. Kosachev at the XIV Plenum of the Board of the All-Union Partnership of Surgeons (1973) on the basis of the statistical statistics of foreign and foreign authors, who would like to hold 980 types of cyst panaritics, to see how much of a finger was left in the process We may have seen more than 400 ailments per cyst panaritium in the Leningrad City Center for Surgery of the hand, we didn’t have a finger amputation, or, in the number of those who were straightened for a reduction in the growth of finger phalanges, 8%.

The functional results of the ailing people with cyst panaritsia are as follows: saved their profession - 77.4%; saved the patronage of citizenship - 15.4%; have reprimanded the robot for the sukupn_styu of reasons і vіkom - 4.8%; inaccurate views - 2.4%.

E. V. Usoltseva, K. I. Mashkara
Hirurgia ailments and pockets of bristles

Felon- ce gostre fired up the fabric of the finger (or feet). Often it develops on the extreme phalanges of the fingers of the hand as a result of infection through other wounds, pores, pits or pricks. Microtraumas open gates for ailing microbes, which can be used in the middle, wicked into heat. Inflammation can be either staphylococcal viclicano, streptococcal or enterococcal, as well as micro-pathogenic microflora.

The ignition process can be widespread on the dermis, the adrenal tissue, and also on the slopes, cysts and tendons of the fingers. Seeing serous (edematous) and gn_yne form panarits_ .

Naybilsh people with inflamed diabetics appear to be infuriating, or suffer from infestations of internal secretions, as well as individuals with impaired blood circulation in other fingers.

symptoms of panaritium

There is a panaritium obov'yazkovo front of microtrauma. At the end of the day, there is a lot of money. There is a pulsating, soft blister in the area where it is lit. Panaritium can be accompanied by chills, increased temperature of til and gallant nezuzhanny.

see felon

They develop a superficial form of panaritism, in case of burning out of the upper ball of dermis and gliboki, in case of which tendon, swelling and cyst tissue are affected.

Superficial views of the panaritia

shkirny vinikє on the toe from the strong side. Gn_y accumulate under the upper ball of shkіri, fixing the mystery behind the muddy vist. Shkіra in the mісці zapalennya chervonіє. Vinikak bil, pechinnya. Iaksho mikhur grows in size, so to inform about those that the ailment is progressing and to switch to more gliboki fabrics.

periungual panaritium(Paronychia) wines when the periungual ridge is ignited. Often the appearance of panaritism is the result of improper manicure. To ignite the nail roller skirting at the edge of the nail as a result of other skins (bullying, other tricky things or porizi).

Glibokі vidi panaritsіyu

pidshkirny panaritsiy to develop with the pad of your finger. Shkіra of a finger on a pillow is shіlna. If you pretend to be, you can't break through the name, zapalennya pass into the place. With a whole kind of panaritism, there is a persistent pain, with a slight onslaught, a sharp bile. If you do not wait for a day, you can burn a loam, a tendon, or a brush.

subungual panarits_y characterized by firing fabrics with a nigty plate. The reason for such a panaritium can be a splinter or a prick.

tendinous panaritium- a navazhchy view of panarits_yu, can produce up to the trivial deterioration of the rupture of the brush. The finger is swollen, the looseness is framed. When you open your finger, winikє strong beat.

sunglobovy panaritsiy vinikє, as infection penetrates into the empty slope. It can happen if you are wounded, or because there is a lot of suppuration in the soft tissues over the slope. For the whole kind of panaritium, powerfully spindle-like expansion in the area of a slope, intermingling of the crumbling of a slope, soreness during an onslaught of any Russian.

Kistkovo-suglobovoy panaritsiy winikє with the progress of the suglob panaritium. At the same time, the gnarly process of crushing the slopes will burst into the cyst tissue.

kistkovy panaritsiy enemy finger tissue. There is a diagnosis of infection (for example, in case of acute infirmous fractures) or a lot of widening of the infection on the cyst from the adjacent tissues.

Panaritium, especially gliboky, will generally require lykuvannya. At the zanedbanyu stanі zapalennya widen on all fabrics of the finger, brush and navіt beforeplіchchya, pandactіlіt develops. To eat, in one way zupiniti widening suppuration є amputation.

prophylactic panaritium

For the prevention of panaritium in case of cutaneous, to nip an insignificant pinched finger, it is necessary to cover the wound with an antiseptic (iodine, water peroxide, alcoholic solution, etc.).

An important part of the prevention of panaritium is cleanliness of hands. However, it doesn’t go into oblivion, but on overdried by squeaky zasob, there are other troughs, through which ailing microorganisms can penetrate. This is not a slid to admit a zesty shkiri shkiri.

When you pick up robots in the city, you need to wear mittens. It’s not a lot of mobility, for bazhannya koristuvatis with mittens - you need to cover your hands with a creamy cream in front of the robot and the voluptuous - send.

It is necessary to be respectful, if the mother is informed about the working tools and the brood: for example, when the cartoons are cleaned. Vegetables must be more beautiful from the ground, and then they must be cleaned. We respect the need for buty when ribbing ribs (pricks with ribbons are a common cause of panarits).

More beautifully, do not koristuvatisya other people's attachments for manikyuru. In case of manikyurі, it is necessary to swallow the yakomoga less traumatizing the cage near the nіgty bed. The cuticle is more beautiful than zrushuvati, and not cut with knives. Carefully clean up the seizures - the stench is often the cause of the periungual felon.

lykuvannya panaritia

Vibir to the method of panaritic treatment to lay down at the stage of congestion and localization of the ignition process.

promptly lykuvannya- held on in different stages superficial types of panaritium, if conservative therapy is already ineffective, and also stagnates at all stages of glide types of panaritism.

For carrying out anesthesia for anesthesia for other reasons, novokain or lidokajin vikonuyut razriz, see gnii, vidmerli fabrics; vstanovlyuyut drainage for vidalennya g_yny together from the wound, apply seams.
The operation is associated with: treatment of seams with antiseptics (furacilinu, BETADIN), internal reception of antibiotics and noxious diseases, optimization with ultraviolet lamps.

Lіkuvannya folk zasoba

Lіkuvannya panaritia folk zasoba will be effective, as zastosovuvati їkh regularly, z cob stage ignited. Iakshcho, do not marvel at all the zusilla, the process is progressing, there is a strong beat, a bulge, self-esteem and temperature rise, self-smoking needs to be tightened and turned up to a surgeon.

manganese... On the cob, it is possible to use a warm bath for a finger with a manganese rose. Trimati finger in the range of up to 30 minutes. Also for the bath, you can vikoristovuvati tincture of Evkalipta or calendula. For a whole 1 h. A spoonful of the infusion needs to be added to a bottle of warm water.
Gorilka (compress)... Wet the cotton wool or gauze with a thin layer, apply it to the point of igniting and bandaging. In the world of psychoanalysis - I know the feeling of bitterness. Wear the bandage for 10-12 years. If necessary, repeat the procedure for three days until symptoms of panaritium are detected. At the pov'yaztsi do not vikoristovuvati compress paper and cellophane, so do not dissolve the effect of the compressing compress.
paraffin... For a panaritism to be fired at a non-technical stage, it is necessary to melt a little paraffin in a water bath in a small community. Then gently burn your finger in paraffin for one second. Repeat the procedure kіlka razіv. As a result, on your fingers, you can pretend to fill your fingers with paraffin. Finger can be used to catch paraffin again, and a finger can be smeared with iodine or alcohol.
Wheat abo ryto... Apply wheat to the urazhenny m_stsya zhuvannya or zhito, cover the top with Sirim kapusta leaf and bandage. Take off the skin bandage for 12 years. Good vityagu gniy.
brilliant green... To relieve pain during panaritium, it is necessary to kindly steam your finger, then flood the little green light. Z shmatochka vati twist a jgutik. For the sake of being ignorant in that moment, de-ignited. Don't be too stuck on the hull or change.
Midniy vitriol... A pinch of honey vitriol in 50 ml of warm water. Trim ailments finger in size with a stretch of 15 quilins. Panaritium will go through decilkoh procedures.
scarlet... See the bottom aloe leaf (capital) and soak it with water. See the thorns and grow the leaf of the bridle. Wrap one of the halves of the fuses with your finger pointing downwards and bandage it. Trimati bandage 4 years old.
Tsibulya... To speed up the dosage of panaritium, bake tsibulin or bake tsibulin in milk. Razrіzati navpіl and put on the igniter of the place, fix it with a bandage. Remove the skin bandage for 4 years.
Board mushroom... Razr_zati mushroom-board, put the inner meat to the burnt mushroom. Powdered with ripe spores of the fungus for the very same, like pulp.
cute... Dribno grate on the tertsi gospodarske cute, add the lumpy eggs. Razm_shati to the porridge. I’m ready to put on a ball until the moment I put it on with a ball (close to 1 cm), so that I’ll get more than 0.5 cm of non-smart shkiri. Put on a bandage. Trimati bandage up to two dib. If the wound is not cleansed, repeat the procedure.
Olive oil... Leak the gauze servet olive olives... Take a sap from pine or cedar for a servetka. Prybintuvati to m_stsya zapalennya for the whole night.

In case of cyst panaritsia, cyst tissue is drawn into the ignition process. The most common form of panaritism is the inherited filthy treatment of pediatric panaritism (secondary cystic panaritus), if you want the primary damage of the cyst in case of severe wounds and suppurative subpermatosis.

The class of primary and secondary cystic panaritics is of great importance. With the primary development of cystic panaritus, such as a pediatric one, there is an intense pulsating pain in the lesion of the phalanx. The finger is in the pre-positioned position, the ruff in the mid-phalangeal members, very small, painful. On palpation, the soreness of the entire phalanx is indicated (as seen from the pediatric panaritism). The zagalny camp of a sickly guarded person is in a larger world, not at the other types of panaritia. Inodi there is a chill. The temperature rises to 39-40˚.

The development of a secondary cyst panaritic loan is not less than 7-10 days. In the first days, it is characteristic of the clientele, pummeled by the first change. The pain will subside, the feverish woman will go down to subfebrile, and she will continue to see pus. In case of revision of the wound with a probe, call up the usurized, relieved ostya of the cyst.

At the cob stage of cystic panaritus on roentgenograms, there is osteoporosis and an intermittent growth of cyst tissue. Signs of the regional destruction on the nygty phalanx appear on the 12-14th day, on the main and middle - in 18-20 days from the ear of the disease. In larger terms, the term is meant to mean destruction, even to the complete ruin of the phalanx.

Lіkuvannya cystovyu panaritsіyu only promptly. We are sick with hospitality we are sick, with a dashing pressure of extraordinary hospitalization, when every day there is a sign of hospitality and significant terms of sickness - a planned prolonged period of days.

V early stages, When interconnecting the destruction of the cyst, you can choose organ-saving operations (edge resections, curettage of the cyst). With a significant ruined cyst in a large number of cases, amputation is required.

sunglobovy panaritsiy

In the ignition process, with a shallow panaritia, a midphalangeal or metacarpophalangeal shank, a soft tissue, is produced. In a number of vipadks, the firing process of hostile slopes of the phalanges and the development of cyst-curd panarits.

Suglobovy panaritsii, so it is itself and the cyst, the first and the second. The first thing to do is to see if there are penetrating wounds on the slopes. Particularly not safe in the whole plan, wounds are hammered on the surface, which can be found when hit with a fist. Among them, I especially respect merit the so-called dentitional poems (in Latin Dens - a tooth, ictus - pochtovkh, punch), when they hit them with a fist "in the teeth". The second suglobovy panaritism grows faster and develops as an acceleration of other forms of panaritium, as well as as a result of technical pardons (the reduction of the sunglobovaya capsule of the member), allowed for an hour of prompt participation.

V classy paintings The painful reaction is gradually growing by the hour and is receiving an intense character. More often localize in the area of a bumpy slope, and then expand to the entire finger and hand. The swelling is circularly covered with the whole swell. When a significant amount of serous or gnarly appears in the empty loam, the finger takes a spindle-like shape and we get sick in the bent bed. The axis is ready to try and try the passive guys very painfully. Ailments relieve sleep, appetite, weakness, chills appear, the temperature rises to 38-39˚.

On radiographs of the fingers, start to grow soft tissue in the circumference of the thinned loam, the phenomenon of osteoporosis, which is similar to the degeneration of the cysts, but to take part in the setting of the loam, insisting on the deterioration of the loss of loam

With the development of a cyst-duck panaritium, the pain will change; A characteristic symptom is the appearance of brittle crumbling in a severe slope, with the appearance of such a one, there may be a cystkova crepitus.

Lіkuvannya suglobovyh panarіtsiyu guilty carried out only by the surgeon in the minds of the stationary. Shown before hospitalization - the same as in case of a cyst panaritia. In the early term, the loss of the slope is carried out, in the most recent period, the drainage and production of the empty slope is carried out. With a cyst-suglob panaritium, the resection of the suglob is shown, and with a significant ruptured cyst - amputation.

It is important for the staff of the doctor of the foreign practice to serve the rehabilitation of the ailments from the stationary treatment. In general, it’s like this is done in case of tendon panaritism, however, it’s not possible to force the loss of money in any way, because in the area of damage there may be a lack of evidence in the field of infection, which can be active. In some cases of indications, taking antimicrobial drugs for a whiskey from a hospital, for example, antibacterial therapy (electrophoresis with antibiotics).

Fingers on the hands are most weak to all kinds of other injuries.

In most cases, there is a lack of gardening, because sometimes people do not think about the need to clean such a mixture with an antiseptic.

However, it is through such other wounds in the body that they use a lot of bacteria, as they wick the approved panaritium.

Suppuration appears on the finger. Yak lіkuvati panaritsіy in fallowness in its form, peeped out lower.

see panaritsiy

The gostry gn_yny firing process, which has developed in soft fabrics, or on the naughty curvature of nigtya, is called panaritium. I will show the ways of such a manifestation, including in the minds of the home, to lie down without the middle of the form, in which it manifested itself.

At the same time, you can use a therapeutic infusion.

form felon

Slid vrahovuvati, scho in deyaky neglected vipad without surgical engagement to be offended.

Panaritium can manifest itself in offensive forms:

Shkіrna pryzvid panaritsіyu. Seeing on your fingers is close to nothing. A collection of vernacular and deyakiy pechinnya. Because of these symptoms change for better education and appearance recurrent pain... Shkіra in the mісtsі zapalennya nabuv yaskravo-chervoniy nabryak. When I have accumulated a lot of the upper ball of the shkіrnogo cover, I will set the mikhur, which is a step-by-step improvement. With the presence of a good process, the ignition process expands on the fabric, rots out more.
The periungual form of the disease. Most often, it is through the wrong vison of a manicure, or when shaving off bullies. After 3-5 days after eliminating microtraumas, ill-feeling and the background of the veil. With a slight penetration of infections in the fabric, you can poult the shining swarth with pus. The filling of the periungual roller is called paronychia.
Ніgtyova form. It can be manifested through the little bit of grisly nigty or dead particles of the shkirny cover near the nigty plates. The same form can be manifested in case of a splinter hit, and at the same time, in case of infection. Through the ignition process, there is a swelling of the remaining phalanx of the finger. Press the gniy z-pid nigtya in the end bag to bring it to the end nigtyovy plate... Tilki in the whole vipadku more views fix it up.
Pidshkirny panarits_y. This form appears on the finger tip from the side of the valley. There is an increase in the amount and background of the school. The creations in the soft fabrics cannot be seen through the cradle cover on the fingers. Through the price, after the appearance of the therapeutic inflow, the heat expands to the ligaments, tendons and cyst tissue.
Kistkova form. To appear at the time of the hourly treatment of the foregoing forms of illness, or through visible fractures of the fingers and the general consumption of infections. Qia form winikє to finish rіdko. However, it appears sharply in the superconductor even more unacceptable symptoms.
Suglobova form of getting sick. Most often it manifests itself spirally with cystic panaritium. With a lot of igniting, the finger should be finished with greatness through the beel and strong swelling.
Tendon form. Tse vzhodka raznovid zhvoryuvannya. You can waste the rudimentary building, which can be made to the point of invalidity. required serious love, Often due to surgical involvement.

The first dvi form of the zhvoryuvannya was called the surface panaritium. With this development, the abscess accumulates under the upper epidermal ball of the scalp cover of the finger. Reshta forms are carried out to a big panaritism, and the internal tissue - tendons, ligaments and knuckles - are formed in the development of the process.

symptoms

The development of any kind of panaritium is most often repaired in a state-of-the-art form.

With this, the following symptoms appear:

At the moment, in which the ignition process is localized, a pulsating beat and smirk can be seen.
Shkіra in the mісtsі zapalennya chervonіє, there is a thickening and fluff.
At the point of abscess, the temperature of the skin tends to move.
Through the zvnіshnіy curl of the shkіri, the gnіy (with a superficial panaritsії) will shine through.
You may have an increase in the temperature of a person with a sick person, feeling of aches, chills and weakness, showing a headache.
Z'yavayutsya obmezhennya in the rukhoy building of the finger, its sensitivity can be dulled.
Pain syndrome in case of malignant panaritism manifests itself in an overgrowth form. At the end of the day, it can be unbearable, but it does not allow you to fall asleep, or to visit for a short time. The patronage of a sick person to be involved.

Diagnostics come in for panaritium detection is not foldable. The superficial forms start when you look around. At the development of a glib panaritium, an x-ray is displayed. The availability of the ignition is confirmed upon delivery extravagant analysis blood.

In case of any form of development of the disease, you can show important inheritances for the body. Dwarf microbial microbes can be consumed from the ignition source at the back of the organ.

At the same time, the infection of blood is superfluous. At the connection from the zimmery to the liquor є the most correct solutions with the established panaritium.

If you see it or not, you may have such inheritance if you have a wrong message, if your blood is infected:

The ignition process can be widened not only on soft fabric, but on lymphatic (diagnosed with a lot of lymphodenitis) and blood-bearing judgment.
The loss of a finger through necrosis, ulcers, and tendon.
If the cyst tissue is fired, it is more possible to ruin the cyst (osteomyelitis).
Firing can be tied to all fabrics of the same or decal phalanges of the finger (pandactylite). At the same time, the amputation of the schob is used to unite the expanded process on the basis of the fabric.

Lykarski preparations for lykuvannya

With a stretch of decilkoh the first days of wine in the surface form of panarits on the fingers conservative politics in the home minds.

At the same time, you can buy vikoristani ointments with antiseptics and antibiotics, as well as folk remedies.

Slid vrahovuvati, so dermal intrusions for the day change the chances on the shvidka, the mercy of the gnarly process. With a lot of growth, there is a need for surgical involvement.

In case of bugs with panaritiums, people immediately fix vicoristovuvati antibiotics at once.

However, such a pidhid is incorrect, since it is antibacterial likarski zasobi- a lot of potent drugs, which may be indicative of a number of side effects... Before that, there was often a panaritium of victories through getting to the school of staff.

The majority of antibiotics on them does not seem like a lot of money.

Lykuvannya panaritium on the finger of the hand for the help of antibiotics can be deprived of the signs of the drug. For viznachennya infection, scho vklikal gnіyne zapalennya, it is necessary to vikonati posіv. However, the first hour is required on the first day, but it’s all over the place.

One of the first signs of the drug in case of superficial panaritism is the antibacterial ointment Levomekol for zastosuvannya. Such a zasіb is not only a knight, but a znіmaє zapalennya.

For more important forms, the development of antibiotics in the process wide range vplyu priznachayut orally or vnutr_shnyom'yazovo. Prior to such drugs should be:

ciprofloxacin;
Amoxiclav;
Ceftriaxone.

Likuvannya panaritia budinku

The idea of \ u200b \ u200bwithdrawing a panaritism on the fingers can be continued at home. With all the recommendations of the surgeon, the guilt will be victorious. In case of burial of self-esteem, it is necessary to turn the term up to a lykar.

At the home pharmacy, you can find a panaritium for the treatment. Krim Levomekol, Vishnevsky's ointment or dioxidine ointment, also Levomekol or Netran.

Tsi kosty may be the protagonist of the fire. However, it is generally necessary to read the instructions, so as the drugs may be contraindicated in the stasis.

Dimexidum can be found at the home pharmacy. For the preparation of the compress, it is necessary in the portions of the boiled water that one portion of the preparation has been reached. Having leaked a sterile bandage with such a gap, attach it to the point of ignition and wrap it with polyethylene.

For fixing the compress over the put on a bandage and vitrimuvati with a stretch of 15-30 minutes. Throughout the day, the procedure is repeated three times. Dimexidum with panaritism is not only known to be fired up, but to the process of starting a wound good job to fight against infection.

As a memory slid, it is possible to register the procedure for the cob stage development process. When a hot bath is established, either heat is applied until the moment the blame is ignited. The continuation of such procedures should be carried out to the back of the body.

For a decrease in the number of symptoms in such cases, it is recommended to use a victorian ice. For vikonannya bath the temperature is not guilty of turning 37º C.

Most popular expansion

Lіkuvati panaritsіy on the fingers of the hands, but it is possible, і for the help of folk recipes.

With a superficial panaritium, this will make it possible to see it out.

Among them, there are a number of recipes that do not require trivial preparation and are easy to set up:

Sodov bath. Such a zaposovusya to accelerate the process, to be repaired with a therapeutic infusion. Take two tablespoons of soda for half a liter of boiled and cold water. Three times a day the finger is ignited, it is necessary to trim with a stretch of 15 quills in such a way. After the procedure is followed, ointment is applied on the spot.
Buriak, mixed with sour cream. Zasib zastosovuєtsya yak compress. Grate half a small beet with an additional grater. Add one spoonful of fatty sour cream and, after mixing, put it on the ice cream. Apply polyethylene on top and fasten with a gauze bandage. Compress for the whole night.
Tsibulu baked goods. also Narodny zasib Crushed to a porridge, apply it for a few years, like a self-contained zasib, so that you mix it with one teaspoon of honey and such a bit of wheat bush.
Alcohol with an egg bottle. In 40 ml of pure medicinal alcohol, the dissolution of deposits from the milk jug to the removal of large plastic. Proceed through cheesecloth, tsya porridge white color to apply until the moment I get it. On top of the pad there is a polyethylene and a bandage. A change for such a compress will be visible in 7-8 years, stretching three dib.
Golden vus. This infusion can be sold in a pharmacy. With the presence of 200 ml of a bottle and a growth-resistant roseline, it can be prepared on its own. Homemade infusion from a finely grated leaf of a golden vus and a gore is guilty of lasting six years. A trimati finger in this way is close to half a year.

For a vikonannya a bath can vikoristovatisya:

medium vitriol (one pinch in a glass of water);
manganese;
seafood;
liquid herbs;
detailing the hour;
kitchen sil.

Vikonannya lіkuvannya panaritsіyu on the fingers of our hands, or they can, for help, complete the great rendition of recipes of folk medicine.

With a lot of memory, for the help of such a happy person it will be effective to get rid of the surface of the form of getting sick.

In case of severe forms, for example, a wounded fracture, independent treatment is not possible.

Hirurgicne involvement

At times of the day there is a polish during the visit drug therapy for when there is a lot of brutality for likarskoy assistance, surgical involvement is necessary. At the same time, the rosin of the gn_ynik is required.

Sorrowfulness vikonutsya mіstseve, for which nadriz is carried out over the mіsznogo zapalyannya. The gn_y is cleaned, but the fabrics are not seen. At the time of the growth of the gnarist, the plate must be visible.

When the rosette was burned, it was shown that the wound was cleaned with an antiseptic solution, and an antibiotic was injected into it. Needed dressings. In most cases, a course of antibiotics and drugs is prescribed, which will give a quick suppression of the wound.

Hirurgical involvement in the development of large forms of panaritism is most often stagnated through the government, the need to preserve the finger building.

It is necessary for the nobility, to prevent the surgical involvement of an attack until the panaritism is triggered immediately after being ignited. When the grip on the nail is repaired, as well as the small pad of the finger appears most of the time, then the cob of the firing process is ready.

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