The analysis of the dynamics of mechanic-and-acoustic state of forearm congenital stump integumentary tissues for surgical lengthening according to Ilizarov

The analysis of the dynamics of integumentary tissue mechanic-and-acoustic state has been made under the conditions of forearm congenital stump surgical lengthening using a skin analyzer (ASA-4) for the purpose of preparation to upper limb prosthetics. Osteosynthesis of forearm stump and osteotomy of one or both bones were performed in RISC "RTO" clinic in 19 patients at the age of 4-18 years using the Ilizarov fixator. The increase of stump length amounted to 4,3±1,1 cm (range: from 3 to 6 cm), and the amount of lengthening reached 12 cm by several stages (2 subjects). Heterogeneity coefficient A(z,x) for integument tissue testing in all the periods of lengthening was established to be below the similar parameter of intact forearm. Its minimal values amounted to 1,1; maximal value didn't exceed 1,3. A narrow range of changes was noted for acoustic heterogeneity degree in the skin of stump front surface. As for stump face skin in making measurements in different directions, it was revealed that the greatest increase of this value took place in distraction period in case of transverse and oblique diagonal orientation. On the basis of the non-invasive express-diagnostics of stump skin structural-and-mechanical adaptation for lengthening the approaches have been determined to predicting possible soft tissue overextension, stump face perforation with lengthened bone and development of trophic disorders