EL CERRAHİSİ SONRASI GELİŞEN DİJİTAL KONTRAKTÜRDE AKUPUNKTUR UYGULAMASI

Öz

42 yaşındaki bir erkek dişhekiminin Aralık 2015'te meydana gelen trafik kazası sonrası başparmağında dijital bir sinir kesisi sonucunda fizik muayenesinde yara izi, ağrı, tırnakta kayıp vardı. El fonksiyonları ağrılı, 5. parmak tırnak yatağı hasarı ve sol eldeki parçalanmış kırık mevcut idi. El hareketlerinde kısıtlama olan diş hekimi fizik tedavi rehabilitasyonu almasına rağmen, fizyoterapi yeterli olmadı ve kontraktür gelişti. Çünkü el manipülasyonu mümkün değildi. Akupunktur noktaları doğrusal yüzey meridyenlerin adı verilen kanallarda bulunur. Bu noktalar iğneler, akupresür, ultrason, ışık veya elektrik akımı ile uyarılabilir. Yara izi etrafına ve 5. parmak tırnak yatağının kenarına akupunktur uygulandı. Sonuç: Yaklaşık dört seans akupunktur yapıldı ve hastanın tırnak yatağı düzelmeye başladı. Beş ay boyunca o bölgede tırnak büyümesi oldu. Yara bölgesindeki dokuda beslenme ve perfüzyonda bir artış ve dokuda renk değişimi gözlendi. Tartışma: Akupunktur iğnesi batırıldığında hem periferik hem de merkezi sinir sisteminde değişiklikler olur.İğne penetrasyonu ile hem lokalize yerde asetilkolin salınımına hem de spastik ve iskemik kasta vazodilatasyona neden olur. Kuru iğne aynı zamanda miyofasyal ağrının tetik noktasının etkili tedavisinde uygun bir tedavidir. Akupunktur tedavisi ile hastanın el kontraktürü ve fonksiyon kaybı ortadan kaldırıldı. Sonuç olarak, akupunktur, kontraktür ve fonksiyon kaybı tedavisinde tercih edilebilecek yöntem olarak görünmektedir.

Anahtar Kelimeler

• Akupunktur
• Skar dokusu
• Dijital kontraktür

APPLICATION OF ACUPUNCTURE IN DIGITAL CONTRACTING AFTER HAND SURGERY

Öz

A 42-year-old dentist had a digital nerve cut in the thumb after a traffic accident in December 2015. There were scarring, pain, loss of function, 5th finger nail bed damage and fragmented fracture in the left hand. Although the restriction in the hand movements of the dentist received physical therapy rehabilitation, physiotherapy was not sufficient, contracture developed and hand manipulation was not possible. With acupuncture treatment, the patient's contracture and loss of function were eliminated. It is a treatment modality that can be preferred in the treatment of acupuncture contracture and loss of function. Acupuncture points are located on the linear surface meridians, canals. These points can be stimulated by needles, acupressure, ultrasound, light or electric current. A 42-year-old dentist had a digital nerve cut in the thumb after a traffic accident in December 2015. Left hand 1-2. There was scarring, pain, loss of function, 5th finger nail bed damage and fragmented fracture in the dorsal between metacarp. Despite the limited physical movement rehabilitation of the dentist's hand movements, physiotherapy was not sufficient, and contracture developed and hand manipulation was not possible. Acupuncture was applied around the 4 scars scar (fig.2,4) and the edge of the 5th finger nail bed (fig.3). Result: Approximately four sessions of acupuncture were performed and the nail bed of the patient started to improve. There was a prolonged nail growth for five months (fig.5). An increase in nutrition at the wound site, an increase in perfusion were observed. Color change was observed in the tissue. Discussion: When the acupuncture needle is immersed, there are changes in both the peripheral and central nervous system. Needle sticking causes acetylcholine release in the localized place and vasodilation in the spastic and ischemic muscle. Dry needle is an appropriate treatment in the effective treatment of the trigger point of myofascial pain

Anahtar Kelimeler

• Acupuncture
• Scar tissue
• Digital contracture

Kaynakça

1. 1. Stanley F Wainapel, Stephanie Rand, Loren M Fishman, Jennifer Halstead-Kenny. Integrating complementary/alternative medicine into pramery care: evaluating the evidence and appropiate implementation. International Journal of Medicine. 2015;8:361-372.
2. 2. Domes CM, Kruger CL Therapists, Trainers, and Acupuncturists: Focused Review for the Orthopedic Surgeon.Orhopedics.2015 December 38(2) e1121-6.
3. 3. Cheng KJ. Review Neurobiological mechanisms of acupuncture for some common illnesses: a clinician’s perspective. J Acupunct Meridian Stud. 2014 Jun; 7(3):105-14.
4. 4. Menzel D. Fundamental Formulas of Physics. New York: Dover Books; 1960
5. 5. Helms JM. Acupuncture Energetics. New York: Thieme Publishers; 1995.
6. 6. Pomeranz B. Acupuncture analgesia basic research. In: Stux G, Hammerschlag R, editors. Clinical Acupuncture, Scientific Basis. Berlin: Springer; 2001. pp. 1–28
7. 7. Kuwazawa J. Experimental research on acupuncture effect on local muscle pain: VI. Effect of vasodilators and neuropeptide on recovery from the reduced twitch after tetanic stimulation. J Showa Med Assoc.1987;47:15–22
8. 8. Daddona MM, Haldar J Opioid modulation of oxytocin release from spinal cord synaptosomes. Neuroreport. 1994 Sep 8; 5(14):1833-5.

9. 9. Vibes J. A-Delta fibers: the essential support of the acupunctural phenomenon?Acupuncture. 1990;1(5):100–102
10. 10. Chiang CY. Peripheral afferent pathway for acupuncture analgesia. Sci Sin B. 1973;16:210–217
11. 11. Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE,Sherman KJ, Witt CM, Linde K, Acupuncture Trialists’ Collaboration. Review Acupuncture for chronic pain: individual patient data meta-analysis Arch Intern Med. 2012 Oct 22; 172(19):1444-53.