Aesthetics in Hand Surgery

8/18/2019 Aesthetics in Hand Surgery

1/169

DHP[MH[F@P FG MDGK PXQIHQV?BQNL QH@NGP[QX@[FNG [N QHOXRHGD[FNG

Ldttmfhu AHXP[HP-P[HBDGHJJF, LKUjdstf` Purihry & Mdgk Purihry

Udrfs, Brdg`h


2/169

F) Dhstmhtf` `ngsfkhrdtfngs fg mdgk surihry

FF) Mdgk dhstmhtf` rh`ngstru`tfng

FFF) Mdgk rhouvhgdtfng



3/169






4/169

! Dhstmhtf` ugfts nb Lf`mng

! Dkdptdthk Pcfg fg`fsfngs

! Lfgf-fgvdsfvh surihry (hgkns`npy, drtmrns`npy)

! @ngshrvdtfng nb tmh knrsdj dsph`t nb tmh mdgk dgk tmh bnrhdrl

! Gn scfg irdbts ng tmh pdjldr dsph`t nb mdgk dgk pujp

! Pcfg irdbt dgk bjdp kngnr sfths

! ht`…

DHP[MH[F@ @NGPFKHQD[FNGP

FG MDGK PXQIHQV


5/169

! Dhstmhtf` ugfts nb tmh mdgk (Lf`mng)


6/169

Gng-lhsmhk scfg irdbt rhsph`tfgi dhstmhtf` ugfts

nb tmh knrsul nb tmh mdgk dgk tmh bfgihrs


7/169

! Dkdptdthk Pcfg fg`fsfngs

Udjldfrhs +++ Knrsdjhs +

Jdtærdjhs +++


8/169

Qhsph`t tmh scfg thgsfng jfghs nb Jdgihr


9/169

! Lfgf-fgvdsfvh Purihry

" rhku`hs s`drs

hx? Cgfbh jfimt® bnr @[P

hx ? Yrfst tmhrdphutf` drtmrns`npy


10/169

! @ngshrvdtfng nb tmh knrsdj dsph`tnb tmh mdgk dgk tmh bnrhdrl

. Dvnfk knrsdj s`drs

. Gn lhsmhk scfg irdbts

. [mfg bjdps

. Dvnfk FNU bjdp fg `mfjkrhg nr ynugi wnlhg


11/169

Xgdhstmhtf` dsph`tnb d lhsmhk scfg irdbt


12/169

Irnfg bjdp tnn tmf`c


13/169

! Dvnfk scfg irdbts fg pdjl dgk pujp

hx ? Ufilhgthk dgk mhdry Bujj [mf`cghss Pcfg Irdbt


14/169

Kdy 14

1 lngtm

Ld` @dsm prn`hkurh

(nphg pdjl) +++fg Kupuytrhg‖s kfshdsh


15/169

! Ah `drhbuj wftm tmh `mnf`h dgk tmh qudjfty nb mdrvhstfgi nb kngnrsfths

Pcfg irdbt tnn tmf`c


16/169

Bujj tmf`cghss scfg irdbt mdrvhsthk fg tmh irnfg nb d ajd`c pdtfhgt bnr tmh pdjl


17/169

Lhkfdj dsph`t nb tmh drl tn mdrvhst djdrih bujj tmf`cghss scfg irdbt


18/169






19/169

4 ! Qmuldtfsldj Khbnrldtfngs wftmnut pdfg+++ KFUO drtmrftfs

+ Qmuldtnfk Drtmrftfs+ 4st @L@ Drtmrftfs

1 ! Knrsdj Kupuytrhg‖s kfshdsh

0 ! @ngihgftdj ldjbnrldtfngs

; ! Phquhjdh nb trdulds nb tmh bfgihrtfp

8 ! Dlputdtfngs (dhstmhtf` dlputdtfngs, dhstmhtf` prnstmhshs)

2 ! @utdghnus khbh`ts

9 ! Pua`utdghnus khbh`ts

= ! Pcfg surbd`h kfsnrkhrs

! ht`…

MDGK DHP[MH[F@ QH@NGP[QX@[FNG

D) Mdgk rh`ngstru`tfvh surihry bnr dhstmhtf` fgkf`dtfngsA) Dkouvdgt trhdtlhgts (dhstmhtf` prnstmhshs, khrldtnjnif`djtrhdtlhgts)


20/169

4 ! KFUO Drtmrftfs(lnst `nllng dhstmhtf` fgkf`dtfng fg mdgks)

0 `ngshrvdtfvh th`mgfquhs +++

" `nrtf`nfk fgoh`tfngs

" Qnldgn‖s KFUO drtmrnpjdsty

" KFUO Pwdgsng Urnstmhsfs (sfzh 5)

Fb Drtmrnkhsfs ?

" dt 5µ nb hxthgsfng

" angh irdbt fb lfkkjh bfgihr

Lu`nfk `yst Mhahrkhg‖s gnkuj


21/169

Qnldgn‖s KFUO Drtmrnpjdsty

# Lf`rnjfbt nb tmh scfg ? « Autthrbjy ³ khsfig


22/169

! Khbdttfgi nb tmh ; bjdps

! Qhsh`tfng nb snbt tfssuh

# Qhsh`tfng nb tmh jdthrdj nsthnpmytfs

# Qhsh`tfng nb tmh knrsdj nsthnpmytfsugkhr tmh hxthgsnr thgkng vhryprh`dutfnusjy


23/169

! Pcfg `jnsurh fg RV


24/169

; lngtms

`nlprhssfng

RV


25/169

KFUK Pwdgsng Urnstmhsfs(sfzh 5)


26/169

KFUO Drtmrnkhsfs nb lfkkjh bfgihr?

- dt 5µ nb hxthgsfng

- wftm angh irdbt tn chhp tmh jhgitm


27/169

4 ! Qmuldtnfk drtmrftfs


28/169

4 ! 4st @L@ drtmrftfs


29/169

1 ! Knrsdj Kupuytrhg‖s kfshdsh

Cgu`cjh pdks


30/169

0 ! @ngihgftdj ldjbnrldtfngs

" dhstmhtf` fgkf`dtfng fg 68% nb `dshs


31/169

; ! Phquhjdh nb bfgihrtfp trdulds

hx ? Gdfj `nlpjhxvds`ujdrfzhk trdgsbhr


32/169

@urvhk gdfj

hx ? gdfj strfdtfng dgk bfxdtfng + fsjdgk bjdp +/-angh irdbt


33/169

8 ! Dlputdtfngs

hx ? lfkkjh bfgihr dhstmhtf` dlputdtfngay fgtrd-`drpdj nsthntnly nb Jh Rfht

¤ Dhstmhtf` surif`dj dlputdtfngs


34/169

Ufjjht Mdgk Urnstmhsfs (UMU), Udrfs - Brdg`h

[mula

¤ Dhstmhtf` mdgk prnstmhshs


35/169

Jngi bfgihrs

trduld

`ngihgftdj


36/169

Udrtfdj Mdgks

trduld

`ngihgftdj

t


37/169

[ntdj mdgk

trduld

`ngihgftdj


38/169

Bnrhdrl


39/169

Drl


40/169

Urnstmhsfs dbthr rh`ngstru`tfvh surihry

Gng dhstmhtf` pmdjdgifsdtfng nb ;

lhtd`drpdjs

Udrtfdj mdgk prnstmhsfs


41/169

[nh trdgsbhr bnr tmh bug`tfng Jngi tmula prnstmhsfs tn flprnvhdhstmhtf` dsph`t


42/169

Irnfg bjdp? tnn aujcy

2 " @utdghnus khbh`ts


43/169

Pcfg suastftuths nr bds`fdj bjdps lnrh dkdpthk


44/169

hx? ujgdr pdjsy wftm dlyntrnpmy nb fgthrnsshnus lus`jhs

9 " Pua`utdghnus khbh`ts

bdt irdbtfgi +++


45/169


46/169


47/169


48/169

. Ldjdkfh kh Kupuytrhg å ug stdkh præ`n`h (F nu FF)hx? Kupuytrhg‖s kfshdsh (hdrjy stdihs)


49/169

!!! #$ %&&'(#%)#'$ *#)+ ,-.(/)%$-'/& %,'$-5.')'41 01 $--;8- 29= 6'5#/&?


50/169

Myphrpfilhgthk scfg irdbt T swft`mhk Jdshr

= " Pcfg surbd`h kfsnrkhrs


51/169

[nh trdgsbhr wftm mdfr" Hpfjdtnry Jdshr


52/169

[dttnn ng tmh mdgk knrsul " Jdshr Vdi T swft`mhk


53/169






54/169

Yftm tmh khvhjnplhgtnb bd`fdj rhouvhgdtfng,

dpphdr snlh pdrdknxdjsftudtfngs wmhrh bd`hdifgi dgk mdgks difgi

kn gnt `nrrhspngk…

‚Ldknggd sygkrnl‚


55/169

YH @DG @MDGIH HRHQV[MFGI FG D YNLDG,

MHQ MDGKP YFJJ DJYDVP PMNY MHQ DIH…>

MDGK QHOXRHGD[FNG

Mdgk dhstmhtf`s fg lhkf`dj lhhtfgis


56/169

Mdgk dhstmhtf`s fg lhkf`dj lhhtfgis

¤ Ahbnrh 1559? ngjy bhw fsnjdthk brhh pdphrs

¤ 4st LHID MDGK Pylpnsful (Bharudry 155=, Udrfs, 4 kdy)

¤ DLY@ @ngirhss (Dprfj 155=, Udrfs, d shssfng nb 1 mnurs)

¤ BHPPM @ngirhss (Ough 155=, Jdusdggh, d shssfng nb 1 mnurs)

¤ FL@DP @ngirhss (Odgudry 1556, Udrfs, d shssfng nb 4 mnur)¤ 1gk LHID MDGK Pylpnsful (Bharudry 1556, Udrfs, 1 kdys)

¤ DLY@ @ngirhss (Ldr`m 1556, Lngd`n, d shssfng nb 1 mnurs)

¤ PNB@HU @ngirhss (Dprfj 1556, @dgghs, d shssfng nb ;8 lfguths)

¤ 0rk

LHID MDGK Pylpnsful (Ldr`m 1545, Udrfs)

¤ ;tm LHID MDGK Pylpnsful (N`tnahr 1544, Udrfs)

¤ 8tm LHID MDGK Pylpnsful (N`tnahr 1541, Udrfs)

¤ 2tm LHID MDGK Pylpnsful (Phpt 1540, Gf`h)? 4st f@jdss Mdgk


57/169

Mdgk rhouvhgdtfng

Ymy sn jdth>

. wh kng‖t jnnc nur mdgks fg tmh lfrrnr

. wh kng‖t tdch pf`turhs nb nur mdgks

. mdgk difgi fs jdthr tmdg bd`h difgi

. dgk djsn ah`dush nb tmh sph`fbf` dgdtnly nb tmh mdgk wmf`mfgku`hs bhdr fg ldgy pmysf`fdgs dgk sjnwhk knwg tmh

khvhjnplhgt nb mdgk rhouvhgdtfng th`mgfquhs…

P f j b m k f


58/169

Phlfnjniy nb mdgk difgi (+++ knrsdj, ++ jdthrdj, + pdjldr)

FG[QFGPF@ DIFGI (dih)

¤ Pcfg < khrldtnpnrnsfs

- hpfkhrldj dtrnpmy

- khrldj dtrnpmy

¤ Bdt dtrnpmy

¤ Lus`jhs < dlyntrnpmy

¤ Rhsshjs brdifjfty # spngtdghnus mhldtnlds

¤ Gdfjs (difgi gdfjs)

¤ Onfgts < khbnrldtfng (KFUO dgk 4st @L@ drtmrnsfs +++)

H][QFGPF@ PCFG DIFGI (sug +++, slncfgi +)

< khrldtnmhjfnsfs? kdrc spnts +++ / bfgh wrfgcjhs +

# kryghss

# schjhtngfzdtfng (vhfgs, thgkngs dgk schjhtng tnn lu`m vfsfajh)

# ihghrdj dsph`t tmfgghr dgk jngihr

# scfg trdgspdrhg`h dgk brdifjfty (`fidrhtth pdphr scfg)

# scfg sdiifgi (khhp wrfgcjhs)


59/169


60/169


61/169


62/169


63/169


64/169


65/169


66/169


67/169


68/169

Mdgk rhouvhgdtfng trhdtlhgts


69/169

d k hou h dt n t hdt h tsPXQIF@DJ [QHD[LHG[P?

¤ Jfbtfgis

¤ Bdt irdbtfgi

¤ Khrldj irdbts? dutnjninus (smhht nr `rusmhk+fgoh`thk ) nr djjnihgf` (hx? Djjnkhrl® )

¤ Khrldj-bdt irdbtfgi (hg ajn` nr fgoh`thk shpdrdthjy)

¤ Bds`fdj irdbts (thlpnrdjfs bds`fd, bds`fd jdtd, juladr bds`fd)

¤ Khrldj Puastftuths wftm 4 sthp prn`hkurh (Fgthird® KQ[ Pfgijh Jdyhr, Ldtrfkhrl® 4ll)

¤ Ujfdajh afnldthrfdj smhhts (Pfjf`ngh, Inrh-thx ® )

¤ Ujdsld fgoh`tfngs (UQU, UQIB)

¤ Umjhah`tnlfhs

¤ @nrrh`tfng nb onfgt drtmrnsf` khbnrldtfngs (KFUO, 4st @L@, …)

LHKF@DJ [QHD[LHG[P?

¤ Pygtmhtf` Bfjjhrs (MD, NMdpdtfth, UJD, @njjdihgh, Pfjf`ngh) / Lhsntmhrdpy

¤ Qdkfdtfngs? Jdshrs, Jfimts ( FUJ , JHK), Umntntmhrdpy (UK[), Qdkfnbrhquhg`y

¤ @mhlf`dj phhjs

¤ Khrldardsfng dgk lf`rnkhrldardsfng / Pcfg ghhkjfgi

¤ @dranxytmhrdpy

¤ Rhfg s`jhrntmhrdpfhs

¤ Gdfj rhouvhgdtfng

DKOXRDG[ [QHD[LHG[P?

¤ @nslh`hutf`s (lnfsturfzfgi, dgtf-nxykdgts, ̀ nnjfgi, snjdr s`rhhg, khpfilhgtdgts, …)

¤ Dgtf-Difgi Lhkf`fgh (kfhtdry dkvf`hs, bnnk suppjhlhgts, vftdlfgs, mnrlnghs, slncfgi stnp…)



70/169

PXQIF@DJ [QHD[LHG[P?

¤ Jfbtfgis

¤ Bdt irdbtfgi


¤ Khrldj-bdt irdbtfgi (hg ajn` nr fgoh`thk shpdrdthjy)

¤ Bds`fdj irdbts (thlpnrdjfs bds`fd, bds`fd jdtd, juladr bds`fd)




¤ Umjhah`tnlfhs


LHKF@DJ [QHD[LHG[P?


¤ Qdkfdtfngs? Jdshrs, Jfimts ( FUJ , JHK), Umntntmhrdpy (UK[), Qdkfnbrhquhg`y

¤ @mhlf`dj phhjs


¤ @dranxytmhrdpy






o

Mdgkjfbts


71/169

MdgkjfbtsKnrsdj s`dr

(Yhgkt)

Xjgdr s`dr

Udjldr + @nllfssurdj s`dr(Pdbbdr)


72/169

Fgvdsfvh QhouvhgdtfngDutnjninus

Khrldj irdbts


73/169

Djjnkhrl℡IDG@MF U., XPD

UMJHAH@[NLFHP


74/169

Fg `dshs nb vhfgs lnrh tmdg 2-9 ll nb kfdlhthrGN LNQH [MDG 4 nr 1 RHFGP +++

UMJHAH@[NLFHP

! Umjhah`tnly


75/169

! Umjhah`tnly


76/169


77/169


78/169

KFUO LF@QNJFB[ « autthrbjy ³ (Qnldgn)


79/169

KFUO LF@QNJFB[ « autthrbjy ³ (Qnldgn)


80/169

BD[ IQDB[FGI

1 prn`hkurhs?

Bnurgfhr‖s prn`hkurh (njk)! diirhssfvh dspfrdtfng, gn `hgtrfbuidtfng, afi `dgujds, afi vnjulhs

< lnrh rhsnratfng (1 prn`hkurhs), julps fg 48%

@njhldg‖s prn`hkurh (ghw)!

snbt dspfrdtfng, `hgtrfbuidtfng, sldjj `dgujds, sldjj vnjulhs< jhss rhsnratfng (4 prn`hkurh)

! fg`rhdshk rdth nb DkP@ < trnpmf` hbbh`t

Yh ush tmh @njhldg‖s prn`hkurh


81/169

UB Bnurgfhr, Udrfs


82/169

15 `` fg tmh knrsul nb tmh wrfstay ngh fg`fsfng

@jnsurh nb tmh bfst

Mnlnihghnus kfstrfautfng


83/169

Lftz lnkfbf`dtfng ?lujtfpjhs fg`fsfngs dgk @rfss`rnss bdt irdbtfgi

BD[ FLLHKFD[H DGK KFQH@[ MDQRHP[FGI


84/169

BD[ FLLHKFD[H DGK KFQH@[ MDQRHP[FGI

; ll `dgujdsdspfrdtfng

Gn `hgtrfbuidtfng


85/169


86/169


87/169

15 `` syrfgihs


88/169

1 ll `dgujds bnr fgoh`tfng


89/169


90/169


91/169


92/169


93/169


94/169


95/169

" Gn ghhk nb sph`fbf` ldthrfdj

" Pmnrt

" 85 tn 95% nb rhsnratfng (ghhk nb 4 tn 1 ntmhrs fgoh`tfngs)" julps fg 48%, tn rhlnvh

" gng mnlnihghnus kfstrfautfng nb tmh bdt

Dkvdgtdihs nb Bnurgfhr‖s prn`hkurh

Kfsdkvdgtdihs nb Bnurgfhr‖s prn`hkurh


96/169

Julps fg 48% (bdtty `yst)

! Jfpnstru`turh nb tmh knrsul nb tmh mdgk


97/169

! Jfpnstru`turh nb tmh knrsul nb tmh mdgk

Pykghy @NJHLDG, GV


98/169

" ngjy 05% nb bdt rhsnratfng (gn ghhk nb 1gk prn`hkurh)

" gn julps

" trnpmf` hbbh`t khlngstrdthk

" sph`fbf` ldthrfdj

" jngi prn`hkurh

Dkvdgtdihs nb @njhldgs‖ prn`hkurh

Kfsdkvdgtdihs nb @njhldgs‖ prn`hkurh


99/169

AVQNG® `dgujds


100/169

Dspfrdtfng (1 ll) Fgoh`tfng (4 ll)

Mdrvhstfgi nb tmh bdtty tfssuh(dspfrdtfng ugkhr jnw khprhssfng)


101/169

(dspfrdtfng ugkhr jnw khprhssfng)

45 `` syrfgih

1 ll `dgujd


102/169

`hgtrfbuidtfng


103/169

@njhldg‖s `hgtrfbuidtfng prntn`nj

? 0lfguths dt 0555 r.p.l

0 `nlpnghgts ? nfjbdtajnnk


104/169

ajnnk


105/169

Qhlnvdj nb tmh nfj dgk tmhajnnk


106/169


107/169

4 `` syrfgih


108/169

4 ll fgoh`tfng `dgujds

[h`mgfquh nb stru`turdj bdt irdbtfgi


109/169

[h`mgfquh nb stru`turdj bdt irdbtfgi

@rhdtfng nb d tugghj wftm tmh 4 ll `dgujd


110/169

Fgoh`tfng infgi ad`cwdrk fg tmh tugghj oust `rhdthk


111/169

Lujtf-jdyhr dgk lujtf-kfrh`tfng fgoh`tfng


112/169

rhvds`ujdrfzdtfng

BD[ IQDB[FGI (@njhldg‖s prn`hkurh)


113/169

BD[ IQDB[FGI (@njhldg s prn`hkurh)

45 lfgf-fg`fsfngs 05 ``

Mdgk knrsul

U4

Kfstdj knrsdj

bnrhdrl

[mhgdr

hlfghg`h

Mypntmhgdr

hlfghg`h


114/169

JHRHJ NB IQDB[FGI?

danvh dgk drnugk

tmh vhgnus jdyhr


115/169


116/169

FG@FPFNGP (dbthr jn`djdghstmhsfd dgk shkdtfng)


117/169

QDKFDJ L@U [MXLA FG@FPFNG $ U4 [MXLA


118/169

XJGDQ L@U [MXLA FG@FPFNG $ U4 nb [MXLA


119/169

4st YHA [MXLA dgk FGKH] FG@FPFNGP $ 4st YHA


120/169

4st YHA FGKH] FG@FPFNG $ U4 nb K1-K0-K;


121/169

LFKKJH L@U FG@FPFNG $ U4 nb K1-K0-K;-K8


122/169

XJGDQ L@U JF[[JH BFGIHQ FG@FPFNG $ U4 nb K8


123/169

XJGDQ L@U JF[[JH BFGIHQ FG@FPFNG $ U4 nb K1-K0-K;-K8


124/169

LFKKJH L@U FG@FPFNG $ PUD@HP AH[YHHG L@U


125/169

QDKFDJ L@U [MXLA FG@FPFNG $ L4


126/169

QDKFDJ YQFP[ FG@FPFNG $ KNQPXL nb tmh MDGK

dgk nb tmh YQFP[


127/169

XJGDQ L@U [MXLA FG@FPFNG $ KNQPXL nb tmh MDGK


128/169

4st YHA FGKH] FG@FPFNG $ KNQPXL nb tmh MDGK


129/169

LFKKJH L@U FG@FPFNG $ KNQPXL nb tmh MDGK


130/169

XJGDQ L@U JF[[JH BFGIHQ FG@FPFNG $

KNQPXL nb tmh MDGK


131/169

QDKFDJ YQFP[ FG@FPFNG $ KNQPXL nb tmh MDGKdgk tmh YQFP[

UNP[-NU

krhssfgi wftm hvdpnrdth


132/169

i p`nnjfgi


133/169

Kdy =


134/169

Bdt Irdbtfgi + Pcfg ghhkjfgi (4 yhdr pn.)


135/169

05 ``

Difgi Mdgk


136/169

Kdy 41 Kdy 25

8 y


137/169

Kdy 25

0 y

9 y

= y

bfvh yhdr8 y


138/169

Kdy 25

0 y = y

9 y

8 y


139/169

Kdy 25

0 y

9 y

= y

1 hbbh`ts wftm bdt irdbtfgi d``nrkfgitn @njhldg‖s Urn`hkurh ?


140/169

- Bfjjhr (dkfpn`yths)

- [rnpmf` (sthl `hjjs < DP@)

+++ gulhrnus sthl `hjjs fg tmh bdtty tfssuh (4555tn 8555 `hjj. / `l0)


141/169


142/169

1 hbbh`ts wftm bdt irdbtfgi d``nrkfgi

tn @njhldg‖s Urn`hkurh ?

- Bfjjhr (dkfpn`yths)

- [rnpmf` (sthl `hjjs < DP@)

hx ? shquhjds nb `mhlf`dj phhjfgi dgk `nrtf`nfkfgoh`tfng


143/169

I ? 01.8``


144/169

K ? 18``


145/169

Kdy ;8

= l

0 y


146/169

= l

Kdy ;8 0 y


147/169

Kdy ;8

= l

0 y

@nlafgdtfng wftm UQU

fgoh`tfng


148/169

fgoh`tfng

tn arfgi irnwtm bd`tnrsdgk tn `nrrh`t tmh

hpfkhrldj kystrnpmy


149/169


150/169


151/169

Pdlh `hgtrfbuidtfng khvf`h bnr Bdtdgk UQU


152/169

Bdt irdbtfgi (05 ``) + UQU (45 ``)


¤ Jfbtfgis



153/169

¤ Bdt irdbtfgi


¤ Khrldj-bdt irdbtfgi (hg ajn` nr fgoh`thk shpdrdthjy)¤ Bds`fdj irdbts (thlpnrdjfs bds`fd, bds`fd jdtd, juladr bds`fd)




¤ Umjhah`tnlfhs


LHKF@DJ [QHD[LHG[P?


¤ Qdkfdtfngs? Jdshrs, Jfimts (FUJ, JHK), Umntntmhrdpy (UK[), Qdkfnbrhquhg`y

¤ @mhlf`dj phhjs


¤ @dranxytmhrdpy¤ Rhfg s`jhrntmhrdpfhs





Bfjjhr fgoh`tfngs


154/169

hx? Qdkfhssh

T swft`mhk Jdshrfgku`hs djsn d scfg tfimthgfgi


155/169

. fgku`hs djsn d scfg tfimthgfgi

. Aut lnrh sn`fdj hx`jusfng

FUJ +++


156/169

Pcfg Ghhkjfgi


157/169

Pcfg rnjjhrs

Pcfg stdlp


158/169

Bhrgdgkhs K. @jfg Khrl. 155=312?461-6.


¤ Jfbtfgis

¤ Bdt irdbtfgi



159/169

¤ Bdt irdbtfgi






¤ Umjhah`tnlfhs


LHKF@DJ [QHD[LHG[P?


¤ Qdkfdtfngs? Jdshrs, Jfimts (FUJ, JHK), Umntntmhrdpy (UK[), Qdkfnbrhquhg`y

¤ @mhlf`dj phhjs


¤ @dranxytmhrdpy¤ Rhfg s`jhrntmhrdpfhs





@NPLH@HX[F@P


160/169

UQHRHG[wftm DN] prn-phghtrdtfgi tn stnpbrhh rdkf`djs dt tmh `hjjujdr jhvhj

@NQQH@[Yftm stdfg `nlpjhx

UQN[H@[wftm d pnthgt XR bfjthr

+ +

LNFP[XQF_FGI@QHDL

@NPLH@HX[F@P


161/169

DG[F-DIFGI IJNRH

krhssfgi wftm hvdpnrdth`nnjfgi

LHID MDGK P[QD[HIVPXQIF@DJ [QHD[LHG[P?

¤ Jfbtfgis

¤ Bdt irdbtfgi


162/169

¤ Bdt irdbtfgi





¤ Ujdsld fgoh`tfngs (UQU , UQIB)

¤ Umjhah`tnlfhs


LHKF@DJ [QHD[LHG[P?

¤ Pygtmhtf` Bfjjhrs (MD, NMdpdtfth, UJD, @njjdiígh, Pfjf`ngh) / Lhsntmhrdpy

¤ Qdkfdtfngs? Jdshrs, Jfimts (FUJ, JHK), Umntntmhrdpy (UK[), Qdkfnbrhquhg`y, …

¤ @mhlf`dj phhjs


¤ @dranxytmhrdpy




¤ Pcfg-`drh `rhdls (lnfsturfzfgi, dgtf-nxykdgts, snjdr s`rhhg, khpfilhgtdgts, …)


LHID MDGK P[QD[HIV



163/169

¤

¤ Bdt irdbtfgi ¤ UQU fgoh`tfng

¤ +/- Umjhah`tnlfhs

¤ +/- @nrrh`tfng nb onfgt khbnrldtfngs (KFUO, 4st @L@)

LHKF@DJ [QHD[LHG[P?¤

¤ FUJ

¤

¤ Pcfg Ghhkjfgi

¤



¤

Bnr KFUO drtmrnsfs?Lf`rnjfbt «Autthrbjy³+ Nsthnpmyth`tnly(mdgk surihng)

Bnr khrldtnpnrnsfsGhhkjfgi (pjdstf` surihng)@nslh`hutf`s


164/169

LHID MDGKPtrdthiy

bnr Knrsdj dgk

Jdthrdj MdgkQhouvhgdtfng

(155=)

Bnr vnjulh jnssBdt irdbtfgi + UQU(+/- 4 nr 1 pmjhah`tnlfhs)(pjdstf` surihng)

Mdgk knrsul

U4

Kfstdj knrsdjbnrhdrl

KFUO

[mhgdrhlfghg`h

Mypntmhgdrhlfghg`h

Bnr 4st @L@ drtmrnsfs?4st wha rhjhdsh+ trdphzh`tnly(mdgk surihng)

Bnr kdrc spnts

FUJ (khrldtnjnifst) 4st @L@

« ; jdyhrs ³ th`mgfquh

bnr vnjulh rhstnrdtfng dgk surbd`h

trhdtlhgt nb difgi mdgks


165/169

trhdtlhgt nb difgi mdgks

1 - UQU

0 - PCFG GHHKJFGI

4 - BD[IQDB[FGI

; - @NPLH@HX[F@P

[mh knrsdj mdgk fs tmfg, brdifjh dgk tmhrhbnrh jhss


166/169

dkdpthk tmdg tmh bd`h tn `jdssf`dj rhouvhgdtfgi

prn`hkurhs, wftm d mfimhr rfsc nb fghbbf`fhg`y dgk`nlpjf`dtfngs, tmdt‖s wmy mdgk fs d `mdjjhgifgi drhdbnr rhouvhgdtfng.

Mdgk rhouvhgdtfng rhqufrhs d lujtfkfs`fpjfgdrystrdthiy phrbnrlhk ay sph`fdjfsts cgnwfgi tmhdgdtnly dgk tmh sph`fbftfhs nb tmh mdgk.

Bdt irdbtfgi tnihtmhr wftm UQU fgoh`tfng fs nur bfrst

`mnf`h bnr vnjulh rhstnrdtfng dgk scfg trnpmf`ftyflprnvhlhgt.

DHP[MH[F@P FG MDGK PXQIHQV?


167/169




BQNL QH@NGP[QX@[FNG [N QHOXRHGD[FNG

@NG@JXPFNG« Dhstmhtf`s, ft fs djrhdky bug`tfng ³

Q. Rfjdfg, Brdg`h

[mdgc ynu bnr ynur dtthgtfng


168/169

ldttmfhuahusthsEildfj.`nl

Ldttmfhu AHXP[HP-P[HBDGHJJF, LKUjdstf` Purihry & Mdgk Purihry

Udrfs, Brdg`h

www.lhidmdgk.hu

f@jdss Mdgk 15404st F @ J


169/169

4st Fgthrgdtfngdj ldsthr @jdss wftm Jfvh khlnsng Dhstmhtf` Purihry & Pcfg rhouvhgdtfng nb tmh Mdgk

Gf`h, Brdg`h, Bd`ujty nb Lhkf`fghPhpthlahr 18-12, 1540

Qhifstrdtfng?L@N @NGIQHPwww.l`n`ngirhs.`nl

Nridgfsdtfng?LHID MDGKwww.lhidmdgk.hu

Ur Kulngtfhr

Ur @dsnjfKr Ahusths-Pthbdghjjf

Documents

Aesthetics in Hand Surgery