I?I?NOA?NOAI IOI?IIE CAeI?IA’ss OE?A?IE

OE?A?INUeEEE IAOEIAI-AeINE?AeIEE ?INOEOOO

O?AAIAOIEIA?? OA I?OIIAAe??

AAEIAE* AANEEUe AANEEUeIAE*

OAeE 616.717–001.5–06:616.727.8–009.12–089

O??O?A?*IA E?EOAAIIss ?ICAEIAEUeIEO EIIO?AEOO? I’ssNOEIAI-OAEAIAIAEO
NOAEIA?A O OAI?EO

C IANE?AeEAIE O?AAI AA?OIUeI? E?IOe?AEE

14.01.21 – o?aaiaoieia?y oa i?oiiaae?y

Aaoi?aoa?ao aeena?oaoe?? ia caeiaoooy iaoeiaiai

nooiaiy eaiaeeaeaoa iaaee/ieo iaoe

Ee?a – 1999

5

Aeena?oaoe??th ? ?oeiien.

?iaioa aeeiiaia a Oe?a?inueeiio iaoeiai-aeine?aeiiio ?inoeooo?
o?aaiaoieia?? oa i?oiiaae?? IIC Oe?a?ie, i. Ee?a.

Iaoeiaee ea??aiee : eaiaeeaeao iaaee/ieo iaoe No?aooi Na?a?e Naiaiiae/,
Oe?a?inueeee iaoeiai-aeine?aeiee ?inoeooo o?aaiaoieia?? oa i?oiiaae??,
ea??aiee ee?i?ee i?e?io??o?a?? oa ?aeiino?oeoeaii? o??o?a?? eeno?.

Io?oe?ei? iiiiaioe :

Ae?the Ieeiea Oaaei?iae/ – aeieoi? iaaee/ieo iaoe, i?ioani?, Eao?aao
Aea?aeaaii? i?ai?? N?N?, caa?aeoaa/ a?aeae?eii ieanoe/ii? oa
i?e?inoaeeiii? o??o?a?? ?inoeoooo ee?i?/ii? oa aenia?eiaioaeueii?
o??o?a?? AII Oe?a?ie.

Neey?aiei ?aaai Oeiio?eiae/ – aeieoi? iaaee/ieo iaoe, i?ioani? eaoaae?e
o?aaiaoieia?? oa i?oiiaae?? Iaoe?iiaeueiiai iaaee/iiai oi?aa?neoaoo ?i.
I.I.Aiaiiieueoey, aea?/? Eao?aao Aea?aeaaii? i?ai?? Oe?a?inueei? ?N?,
caneoaeaiee ae?y/ iaoee Oe?a?ie.

I?ia?aeia onoaiiaa : Aei?i?iiao?ianueea aea?aeaaia iaaee/ia aeaaeai?y.

Caoeno a?aeaoaeaoueny “ 26 ” aeiaoiy 1999?. i 1400 aiaeei? a can?aeaii?
niaoe?ae?ciaaii? a/aii? ?aaee Ae 26.606.01 a Oe?a?inueeiio
iaoeiai-aeine?aeiiio ?inoeooo? o?aaiaoieia?? oa i?oiiaae?? (252054,
Ee?a-54, aoe. Ai?ianueeiai, 27).

C aeena?oaoe??th iiaeia iciaeiieoeny o a?ae?ioaoe? Oe?a?inueeiai
iaoeiai-aeine?aeiiai ?inoeoooo o?aaiaoieia?? oa i?oiiaae??.

Aaoi?aoa?ao ?ic?neaii “ 22 ” aa?aniy 1999?.

A/aiee nae?aoa?

niaoe?ae?ciaaii? a/aii? ?aaee,

aeieoi? iaaee/ieo iaoe A.A.Oeauaiei

CAAAEUeIA OA?AEOA?ENOEEA ?IAIOE

Aeooaeuei?noue i?iaeaie. Eenoue, ye iaeaaaeeea?oee i?aai
aeeoo?ae?yeueiino? oa i?aoe?, /ano?oa ?ioeo ae?eyiie o?ea eiioaeoo? c
o?aaioth/eie aaaioaie ye ia ae?iaieoeoa? oae ? a iiaoo?. Iioeiaeaeaiiy
eeno? na?aae ae?iaie/eo o?aai a ?iaeono??aeueia ?icaeiooeo e?a?iao
noaiiaeyoue a?ae 30% aei 60% [A?yioeaaa E.I.,1971; Aieeia I.A., 1975;
Aaneeue?a N.O., 1986; AEeea TH.N.,1986; Greigton J.J.Jr., 1994], a
na?aae i?e/ei ?iaae?aeiino? 12,5% aeiaaee?a iia’ycai? c oe??th
iaoieia??th [Aa?aoaeee I., ‘1989; A?yioeaaa E.I., 1971; Oooo?i 0.0.
1998]. Ia caaaeath/e ia cia/i? oni?oe no/anii? o??o?a?? eeno?,
iacaaeia?euei? ?acoeueoaoe e?eoaaiiy iathoue 38% oai?eo, yeei iaaeathoue
aeiiiiiao o ca’yceo c o?aaiith eeno?. Oea iia’ycaii c? no?eeith
oaiaeaioe??th aei i?aeaeuaiiy aaaeeino? o?aaie eeno?, iaaeinoaoi?i oa
iaye?niei e?eoaaiiyi [Eieiioae TH.TH., 1979]. Iniaeeai? ?ie? o ao?ao?
i?aoeacaeaoiino? oa ?iaae?aeecaoe?? oai?eo iaaoaathoue iane?aeee o?aai,
cie?aia eiio?aeoo?e noaeia?a eeno?. Ca aeaieie Aan?eue?aa N.O.,
ss?iieainueei? E.A. [1990], eiio?aeoo?e noaeia?a iaeueoe?a eeno?
aoaathoue o 51,4% oai?eo c iane?aeeaie o?aai eeno?. Aaaeeeaa cia/aiiy
i?e ao?ao? i?aoeacaeaoiino? ia? iaoieia?y i’ynoeiai-oaeaiaiaeo noaeia?a
(ION), ine?eueee i?e ?icaeiaeueieo eiio?aeoo?ao i’ynoeiai-oaeaiaiaeo
noaeia?a (?EION) eenoue ao?a/a? iniiai? aeaee caoaao?a, a ioaea ? 100%
ooieoe?? [Allis ?.R., 1989]. *anoioa ?EION noaiiaeoue 25,8% a?ae on?o
eiio?aeoo? eeno? [Aaneeue?a N.O., 1990].

Iia?aoe?? ii a?aeiiaeaiith ?oo?a o noaeiaao iaeueoe?a eeno? i?ieoee
aeiaaee oeyo. Ia caaaeath/e ia ??ciiiai?oi?noue iaoiae?a e?eoaaiiy,
a?aeiiaeaiiy ?oo?a o eiio?aaiaaieo noaeiaao iaeueoe?a eeno? caeeoa?oueny
na?eiciith i?iaeaiith no/anii? ?aeiino?oeoeaii? o??o?a?? [Aaaeueoeaa A.
I., 1975; Aaaeo?acaeia O. A.,1984; Eaoa?ia O.I., 1993]. Caiia?aoe
?icaeoeia? ?EION oa a?aeiiaeoe ooieoe?th i?e noi?iiaai?e
eiio?aeoo?? aaaeei c-ca /eneaiieo ao?iiaoiaaiaoe/ieo oaeoi??a,
aiaoiii-ooieoe?iiaeueieo iniaeeainoae ciie -aaeeea e?euee?noue
ae??aieo aaaaoia?nueiaeo noaeia?a, cia/ia e?euee?noue
aaaaoinoaeiaiaeo i’yc?a, nooiaeeeueii-ca’yceiaiai aia?aoa,
iniaeeainoae oe??iiai iie?iao. [Youm Y, 1978; Wilhelm A., 1992; Von
Schroeder H.P., 1993; Rayan G.M., 1997]. Canoa??e? ooeiaeaeaiiy
aiaoii?/ieo no?oeoo? ?c ?iceaaeaie e?iaiia?ao oa ?iia?aaoe??
iio?aaothoue i?aaeeueiiai oaeoe/iiai i?aeoiaeo aei a?aeiiaeaiiy ooieoe??
oa caoiae?a ii caiia?aaiith ?aoeeaeeao [Feldon P.,1987; Creighton
J.J.Jr., 1994].

Eeaneo?eaoe?y ?EION aei oeueiai /ano ua ia ?ic?iaeaia, ia
nenoaiaoeciaaii ao?iiaoiaaiaoe/i? iaoai?cie oi?ioaaiiy ?EION, ia
c’yniaaii ?ieue ?iceaae?a iaoaaie?cio iniiaiiai no?oeoo?iiai a?eea
niieo/ii? oeaieie — eieaaaio, ye? iiaeooue aieeaaoe ia oi?ioaaiiy
i?neyo?aaiaoe/ieo eiio?aeoo?, ia aecia/aii oaeoe/i? e?eoa??? oa no?iee
e?eoaaiiy oai?eo o caeaaeiino? a?ae aaaeeino? oa e?eueeino?
iioeiaeaeaieo aiaoiii-ooieoe?iiaeueieo iniaeeainoae ciie – aaeeea
e?euee?noue ae??aieo aaaaoia?nueiaeo noaeia?a, cia/ia e?euee?noue
aaaaoinoaeiaiaeo i’yc?a, nooiaeeeueii-ca’yceiaiai aia?aoa, iniaeeainoae
oe??iiai iie?iao. [Youm Y., 1978; Wilhelm A., 1992; Von Schroeder H.P.,
1993; Rayan G.M., 1997]. Canoa??e? ooeiaeaeaiiy aiaoii?/ieo no?oeoo? ?c
?iceaaeaie e?iaiia?ao oa ?iia?aaoe?? iio?aaothoue i?aaeeueiiai
oaeoe/iiai i?aeoiaeo aei a?aeiiaeaiiy ooieoe?? oa caoiae?a ii
caiia?aaiith ?aoeeaeeao [Feldon P.,1987; Creighton J.J.Jr., 1994].

Eeaneo?eaoe?y ?EION aei oeueiai /ano ua ia ?ic?iaeaia, ia
nenoaiaoeciaaii ao?iiaoiaaiaoe/i? iaoai?cie oi?ioaaiiy ?EION, ia
c’yniaaii ?ieue ?iceaae?a iaoaaie?cio iniiaiiai no?oeoo?iiai a?eea
niieo/ii? oeaieie – eieaaaio, ye? iiaeooue aieeaaoe ia oi?ioaaiiy
i?neyo?aaiaoe/ieo eiio?aeoo?, ia aecia/aii oaeoe/i? e?eoa??? oa no?iee
e?eoaaiiy oai?eo o caeaaeiino? a?ae aaaeeino? oa e?eueeino?
iioeiaeaeaieo aiaoiii-ooieoe?iiaeueieo no?oeoo?, iaia? no?oiei? nenoaie
i?neyiia?aoe?eii? ?aaa?e?oaoe?? oa iaoiae?a i?io?eaeoeee ?aoeeaeea?a
?EION. Aeeeaaeaia aeua na?ae/eoue i?i iaiao?aei?noue aeeaieiai aea/aiiy
iaoieia?/ieo oaeoi??a, ui aieeaathoue ia oi?ioaaiiy eiio?aeoo? oa
a?iiaoai?ee eeno?, a oaeiae oaeineiiaeaiiy nenoaie i?io?eaeoeee,
e?eoaaiiy ? i?neyiia?aoe?eii? ?aaa?e?oaoe?? oai?eo ?c iane?aeeaie o?aai
aa?oiuei? e?ioe?aee, ia?aa?a i?ioeano o yeeo oneeaaeieany ?EION.

Ca’ycie ?iaioe c iaoeiaeie oaiaie. Iniiai? iaoa??aee aeena?oaoe?? ?
?iaeea?aeoaeueieie o?aaiaioaie ieaiiaeo oai, ui aeeiioaaeenue a Ee?i?oe?
i?e?io??o?a?? oa ?aeiino?oeoeaii? o??o?a?? eeno? Oe?a?inueeiai
iaoeiai-aeine?aeiiai ?inoeoooo o?aaiaoieia?? oa i?oiiaae?? (Oe?IAe?OI)
IIC Oe?a?ie i?ioyaii 1994 – 1999 ?ie?a cie?aia ca ? aea?ae?a?no?aoe??
0194U017447; 0196U017996.

Iaoith ?iaioe ? iie?auaiiy ?acoeueoao?a e?eoaaiiy oai?eo ?c iane?aeeaie
o?aai aa?oiuei? e?ioe?aee, oneeaaeiaieo ?icaeiaeueieie eiio?aeoo?aie
i’ynoeiai-oaeaiaiaeo noaeia?a ia iniia? aea/aiiy oa nenoaiaoecaoe??
ao?iiaoiiaiaoe/ieo iaoai?ci?a oi?ioaaiiy eiio?aeoo?, aiae?co no?oeoo?ieo
? ooieoe?iiaeueieo ci?i o oeaieiao, ?ic?iaee iiaeo ? aaeineiiaeaiiy
?nioth/eo iaoiae?a e?eoaaiiy oa ?aaa?e?oaoe??.

Caaea/? aeine?aeaeaiiy:

— aea/eoe iaoai?cie oi?ioaaiiy ?EION;

— noai?eoe iaoaiaoe/i? iiaeae? oi?ioaaiiy eiio?aeoo? ia iniia?
a?iiaoai?/iiai aiae?co ?oo?a o noaeiaao eeno? oa iaeueoe?a ? aieeao
aeaoi?iaoe?e e?noie eeno? oa ia?aaeie?//y ia ao?ieia?th eiio?aeoo??

— ia iniia? nenoaiaoecaoe?? ao?ieia?/ieo oa iaoiaaiaoe/ieo oaeoi??a
?ic?iaeoe noaio iaoiaaiaco oi?ioaaiiy eiio?aeoo? oa eeaneo?eaoe?th
?EION;

— ?ic?iaeoe iia? ? aaeineiiaeeoe ?nioth/? iaoiaee i?io?eaeoeee ?
e?eoaaiiy eiio?aeoo?, ?ic?iaeoe /?oe? iieacaiiy oa i?ioeiieacaiiy aei
iia?aoeaieo ao?o/aiue;

— aaeineiiaeeoe nenoaio aei- ? i?neyiia?aoe?eii? ?aaa?e?oaoe?? oai?eo ?c
?EION;

— c’ynoaaoe a?io?i?/i? aniaeoe iaoiaaiaco oi?ioaaiiy eiio?aeoo? noaeia?a
iaeueoe?a eeno? ia iniia? aea/aiiy iaoaaie?o?a eieaaaio a aeeiai?oe? ?
?ic?iaeoe iieacaiiy aei ia’?i?a iia?aoeaieo ao?o/aiue a caeaaeiino? a?ae
iniaeeainoae i?ioeano o?a?icoaaiiy;

— aea/eoe ?acoeueoaoe e?eoaaiiy, i?iaanoe aiae?c iiieeie oa oneeaaeiaiue
i?e e?eoaaii? oai?eo c ?EION.

Iaoeiaa iiaecia iaea?aeaieo ?acoeueoao?a:

– aia?oa nenoaiaoeciaaii oa ooi/iaii oaeoi?e, ui aieeaathoue ia ?icaeoie
? oi?ioaaiiy ?EION;

– noai?aii iaoaiaoe/i? iiaeae? oi?ioaaiiy ?EION a caeaaeiino? a?ae
oa?aeoa?o oa nooiaith iaoieia?/ieo ci?i ooieoe?iiaeueieo no?oeoo?
ia?aaeie?//y oa eeno?;

– ?ic?iaeaii noaio iaoiaaiaco oa eeaneo?eaoe?th ?EION;

– aaeineiiaeaii iia?aoe?th iia?e?caoe?? ION, ?ic?iaeaii oa ai?iaaaeaeaii
a i?aeoeeo i?eno??e aeey ?? aeeiiaiiy;

– c’yniaaii iniaeeaino? iai?io eieaaaio oa eiai ?ieue o oi?ioaaii?
?EION, ui aeicaiey? ni?iaiicoaaoe ?acoeueoaoe o??o?a?/iiai e?eoaaiiy;

– iaoeiai iaa?oioiaaii oa ?ic?iaeaii iia? oaeoe/i? i?aeoiaee aei
iine?aeiaiino? oa ianyao aoai?a e?eoaaiiy oai?eo c ?EION;

– aia?oa ?ic?iaeaii aoaeoeaio nenoaio i?io?eaeoeee oa e?eoaaiiy oai?eo c
?EION.

I?aeoe/ia cia/aiiy ?iaioe. Ai?iaaaeaeaiiy cai?iiiiiaaii? nenoaie
i?io?eaeoeee, e?eoaaiiy oa i?neyiia?aoe?eii? ?aaa?e?oaoe?? oai?eo ?c
?EION aeicaiey? cia/ii iie?aueoe ?acoeueoaoe e?eoaaiiy oa cieceoe
??aaiue ?iaae?aeiino? o oai?eo c ?EION. Noai?aia eeaneo?eaoe?y ?EION
aea? iiaeeea?noue aeeoa?aioe?eiaaiiai i?aeoiaeo aei e?eoaaiiy oai?eo ?c
eiio?aeoo?aie, aeiiiiaaa? aecia/eoe oaeoeeo e ianya iaaee/ii? aeiiiiiae
ia ??cieo aoaiao e?eoaaiiy. Ca aeiiiiiaith iaoaiaoe/ieo iiaeaeae, o??o?a
iiaea aecia/eoe iioeiaeuei? caoiaee i?e e?eoaaii? ?EION. Canoinoaaiiy
oaeineiiaeaii? iia?aoe?? iia?e?caoe?? ION oa ai?iaaaeaeaiiy a i?aeoeeo
i?eno?ith aeey ?? aeeiiaiiy cia/ii iie?auo? oaoiieia?th oa ?acoeueoaoe
oeueiai o??o?a?/iiai ao?o/aiiy. Aecia/aiiy oiiiaiai ??aiy iaoaaie?cio
eieaaaia aeicaiey? ni?iaiicoaaoe ?acoeueoaoe o??o?a?/iiai e?eoaaiiy.

Iniaenoee aianie caeiaoaa/a. Aaoi?ii aeena?oaoe?eii? ?iaioe iniaenoi
i?iaaaeaii aiae?c no/aniiai noaio ieoaiiy iane?aee?a o?aai aa?oiuei?
e?ioe?aee oa oi?ioaaiiy ?EION, aiae?c ee?i?/iiai iaoa??aeo oa
?acoeueoao?a e?eoaaiiy, ?ic?iaeaii eeaneo?eaoe?th ?EION, ?ic?iaeaii
nenoaio i?io?eaeoeee oa e?eoaaiiy ?EION, ?ic?iaeaii ? ai?iaaaeaeaii a
i?aeoeeo i?eno??e aeey iia?e?caoe?? ION. Ni?eueii c anenoaioii eaoaae?e
oai?aoe/ii? iaoai?ee IOOO “Ee?anueeee iie?oaoi?/iee ?inoeooo”,
eaiaeeaeaoii oaoi?/ieo iaoe *eaeiaei Ieaen??i Aaea??eiae/ai, ia iniia?
a?iiaoai?/iiai aiae?co no?oeoo?e oa ooieoe?? noaeia?a, noai?aii
iaoaiaoe/i? iiaeae?, ye? aeicaieythoue i???iooaaoeny a aaiac?
i?neyo?aaiaoe/ieo aeaoi?iaoe?e oa aecia/aoe iioeiaeuei? e?eoaaeuei?
caoiaee. Ni?eueii c eieaeoeaii eaai?aoi??? a?io?i?? Oe?a?inueeiai
iaoeiai-aeine?aeiiai ?inoeoooo o?aaiaoieia?? oa i?oiiaae?? i?ae
ea??aieoeoaii aeieoi?a a?ieia?/ieo iaoe Iaaiiaaeiaa N. aeeiiaii
a?io?i?/io /anoeio aeine?aeaeaiue.

Ai?iaaaeaeaiiy a i?aeoeeo. Iaoiaee e?eoaaiiy oa i?neyiia?aoe?eii?
?aaa?e?oaoe?? ai?iaaaeaeaii a i?aeoeeo o ee?i?oe? i?e?io??o?a?? oa
?aeiino?oeoeaii? o??o?a?? eeno? Oe?IAe?OI, Ee?anueeiai i?nueeiai oeaio?o
ieanoe/ii? i?e?io??o?a?? oa o??o?a?? eeno?, ee?i?ee i?e?io??o?a??
Aeiiaoeueeiai iaoeiai-aeine?aeiiai ?inoeoooo o?aaiaoieia??, ee?i?ee
i?e?io??o?a?? oa i?oiiaae?? Oaeai?iaenueei? iaeanii? ee?i?/ii? e?ea?i?,
?ic?neaii ?ioi?iaoe?eiee eeno.

Ai?iaaoe?y ?acoeueoao?a aeena?oaoe??. Iniiai? iieiaeaiiy oa ?acoeueoaoe
?iaioe aeeeaaeaii ia iaoeiai-i?aeoe/ieo eiioa?aioe?yo iieiaeeo a/aieo
Oe?a?inueeiai IAe? o?aaiaoieia?? oa i?oiiaae?? (Ee?a 1991, 1993); ia V??
oeie? e?a?i NIAe c aeooaeueieo ieoaiue a?ieia?? iii?ii-?ooiaiai aia?aoa
(Oa?e?a, 1994), O?? c’?cae? i?oiiaae?a-o?aaiaoieia?a Oe?a?ie
(Ee?a,1996); can?aeaiiyo oiaa?enoaa o?aaiaoieia?a-i?oiiaae?a i. Ee?aa oa
Ee?anueei? iaeano?, (Ee?a,1997); i?aeia?iaei?e iaoeia?e eiioa?aioe??
“Aeooaeuei? ieoaiiy no/anii? o??o?a??” (Oaeai?iae, 1997);
iaoeiai-i?aeoe/ii? eiioa?aioe?? “No/ani? aniaeoe e?eoaaiiy ooeiaeaeaiue
eeno? ? ?o iane?aee?a” (Aei?i?iiao?ianuee, 1998).

Ioae?eaoe??. ?acoeueoaoe aeena?oaoe?? iioae?eiaaii o 4 noaooyo a
iaoeiaeo aeo?iaeao (iaeia aac ni?aaaoi??a), o 8 iaoa??aeao ? oacao
c’?cae?a oa eiioa?aioe?e, iaea?aeaii iaeei iaoaio.

No?oeoo?a oa ianya aeena?oaoe??. ?iaioa aeeeaaeaia ia 150 noi??ieao
iaoeiiieniiai oaenoo ? neeaaea?oueny c? anooio, oanoe ?icae?e?a,
i?aenoieo, aeniiae?a. ?ethno?iaaia 58 ?enoieaie ? 17 oaaeeoeyie. Nienie
aeei?enoaii? e?oa?aoo?e i?noeoue 269 aeaea?ae ?ioi?iaoe??, cie?aia 115
a?o/eciyieo ? 154 ?iicaiieo aaoi??a.

INIIAIEE CI?NO AeENA?OAOe??

Iaoa??aee oa iaoiaee aeine?aeaeaiiy. ?iaioa aaco?oueny ia aiae?c?
?acoeueoao?a ianoaaeaiiy oa e?eoaaiiy 81 oai?iai c ?EION ye?
ciaoiaeeeenue ia e?eoaaii? ca inoaii? 15 ?ie?a o Ee?i?oe? i?e?io??o?a??
oa ?aeiino?oeoeaii? o??o?a?? eeno? Oe?a?inueeiai iaoeiai-aeine?aeiiai
?inoeoooo o?aaiaoieia?? oa i?oiiaae??. Oai?eo ?icae?eeee ia 4 ee?i?/i?
a?oie a caeaaeiino? a?ae aaaeeino? o?aai, ??cieo oaeoe/ieo i?aeoiae?a ?
iaoiae?a e?eoaaiiy. O ia?oi? a?oie — 21 oai?ee, ?icaeiaeuei? eiio?aeoo?e
noi?ioaaeenue o ?acoeueoao? o?aai e?noie ia?aaeie?//y oa eeno?. O
ae?oai? a?oie — 30 oai?eo, aei ?icaeiaeueieo eiio?aeoo? i?eca?a
ia?aeiiee i’yciaee aeenaaeain ia ia?aaeie?//? oa eeno? /a?ac o?aaie
ia?a?a, nooiaeeeue oa ?oai?/iiai ooeiaeaeaiiy oeaiei. O o?aouei? a?oie —
11 oai?eo, aoei iioeiaeaeaiiy ooieoe?iiaeueieo no?oeoo? oeeo eeno? oa
ia?aaeie?//y, ui aoei i?e/eiith oi?ioaaiiy eiio?aeoo?. *aoaa?oa a?oia —
19 oai?eo aoea c eiio?aeoo?aie ci?oaiiai aaiaco. ?acoeueoaoe ianoaaeaiiy
oai?eo c iane?aeeaie o?aai aa?oiuei? e?ioe?aee ia?iaeee ca
oaeineiiaeaiith iaie nenoaiith Aia?eeainueei? anioe?aoe?? o??o?a?a
eeno?.

Aeey aecia/aiiy iniaeeainoae iaoaaie?cio eieaaaio oa ioe?iee
?ioaineaiino? i?ioean?a o?a?icoaaiiy ye iaeii? ?c iniiaieo iiaeeeaeo
i?e/ei oi?ioaaiiy ?EION aecia/aee oae? a?io?i?/i? iieacieee:
a?eeiaica’ycaiee ienei?ie?i (ca iaoiaeii Faao 5.1965),
iaioeaeiica’ycaiee ienei?ie?i oa a?eueiee ienei?ie?i (ca iaoiaeii
Ia?o?eiaa A.I. oa ?io., (1974)), aeoeai?noue oa?iaio?a eaoaineio A (ca
iaoiaeii Burlugh M.C. c ni?aaao., (1974)) ? eieaaaiace (ca iaoiaeii
Lyndy S. (1973)). Iacaai? aeua a?io?i?/i? iieacieee aecia/aee aei
o??o?a?/iiai ao?o/aiiy, /a?ac 10 aei. 1 i?n, 2-4-6 i?n oa 1 ??e i?ney
o??o?a?/iiai ao?o/aiiy i?e ?EION.

Aeey ioe?iee aaee/eie ianeaii? aeneo?n?? nooiaeeeue i’yc?a-?icaeia/?a
iaeueoe?a canoiniaoaaee iaoiae iaoaiaoe/iiai iiaeaethaaiiy. Ia noai?ai?e
iiaeae? aeine?aeaeoaaee caeaaei?noue i?ae eooaie caeiaiiy a ION ?
i?aeoaeaiaiaeo noaeia?a (ION) oa iaiao?aeiei aeey aacia?aoeiaeiiai
caeiaiiy ianeaiei ?icoyaiaiiyi nooiaeeeue ?icaeia/?a. Ae?aiaciie eoo?a
caeiaiiy a noaeiaao caaeaaaeenue o iaaeao o?c?ieia?/ii? ii?ie. Ca
a?aeiieie o?eaiiiiao?e/ieie oi?ioeaie ?ic?aoiaoaaee ci?ie aeiaaeeie
nooiaeeeey ?icaeia/a a caeaaeiino? a?ae eoo?a caeiaiiy a noaeiaao eeno?
oa iaeueoe?a. Aiae?coaaee iiaeeea? i?e/eie aeieeiaiiy ?icaeiaeueieo
eiio?aeoo? i?e ia?aeiiao i’ynoeiaeo e?noie oa eooiaeo aeaoi?iaoe?yo
e?noie ia?aaeie?//y.

Ia aiaoii?/ieo i?aia?aoao aei??yee aeneo?n?? nooiaeeeey ?icaeia/a i?e
??cieo ianyaao ?oo?a o ION oa ION. Aei??thaaee ae?aiao? aie?aie
i’ynoeiaeo e?noie. Aeae?eyee nooiaeeeey ?icaeia/?a iaeueoe?a,
i?aia?oaaee i’yce eeno?. Aea/aee aeneo?n?th nooiaeeeey ?icaeia/a i?e
caeiaeueii-?icaeiaeueieo ?ooao o eenoueiaiio, i’ynoeiai-oaeaiaiaiio
noaeia?, i?ieneiaeueiiio i?aeoaeaiaiaiio noaeia? (IION) oa aeenoaeueiiio
i?aeoaeaiaiaiio noaeia? (AeION) ie?aii ? caaaeueii. Aeey
i?aeoaa?aeaeaiiy aeinoia??iino? oai?aoe/ii-iaoaiaoe/ieo ?ic?aooie?a
oa noai?aii? iaoaiaoe/ii? iiaeae? i?iaaaeai? aiaoii?/i? oa a?iiaoai?/i?
aeine?aeaeaiiy ia 12 na?aeeo aiaoii?/ieo i?aia?aoao ia?aaeie?//y oa
eeno?.

Ia aiaoii?/ieo i?aia?aoao aei??yee aeneo?n?? nooiaeeeey ?icaeia/a i?e
??cieo ianyaao ?oo?a o ION oa ION. Aei??thaaee ae?aiao? aie?aie
i’ynoeiaeo e?noie. Aeae?eyee nooiaeeeey ?icaeia/?a iaeueoe?a,
i?aia?oaaee i’yce eeno?. Aea/aee aeneo?n?th nooiaeeeey ?icaeia/a i?e
caeiaeueii-?icaeiaeueieo ?ooao o eenoueiaiio, i’ynoeiai-oaeaiaiaiio
noaeia?, i?ieneiaeueiiio i?aeoaeaiaiaiio noaeia? (IION) oa aeenoaeueiiio
i?aeoaeaiaiaiio noaeia? (AeION) ie?aii ? caaaeueii. Aeey
i?aeoaa?aeaeaiiy aeinoia??iino? oai?aoe/ii-iaoaiaoe/ieo ?ic?aooie?a oa
noai?aii? iaoaiaoe/ii? iiaeae? i?iaaaeai? aiaoii?/i? oa a?iiaoai?/i?
aeine?aeaeaiiy ia 12 na?aeeo aiaoii?/ieo i?aia?aoao ia?aaeie?//y oa
eeno?.

?ACOEUeOAOE AeINE?AeAEAIIss OA ?O IAAIAI?AIIss

Noai?ai? iaie iaoaiaoe/i? iiaeae? aeicaieythoue i???iooaaoeny a aaiac?
i?neyo?aaiaoe/ieo aeaoi?iaoe?e oa aecia/aoe iioeiaeuei? e?eoaaeuei?
caoiaee, a naia, ia iniia? ooieoe?iiaeueii? noaie ooieoe??
i’ynoeiai-oaeaiaiaiai noaeiao aeaaee ?ic?aooieiao oi?ioeo aeey ioe?iee
aaee/eie aeneo?n?? (?ooiiino?) nooiaeeeea ?icaeia/a iaae
i’ynoeiai-oaeaiaiaei noaeiaii. Aiia aea? iiaeeea?noue o??o?ao o eiaeiiai
ie?aiiai oai?iai a caeaaeiino? a?ae ao?ieia?? (oa?i?/ia aai ?oai?/ia
?ao?aeoe?y i’yc?a oa nooiaeeeue ?icaeia/?a oiui) aecia/eoe iioeiaeueia
iiaeiaaeaiiy nooiaeeeea ?icaeia/a, ui caaacia/o? aenie? ooieoe?iiaeuei?
?acoeueoaoe e?eoaaiiy:

wmetafile8? ???????????????
???????????yyy????.????1?????? ???????
 `???&??yyyy?????AyyyAEyyy ??f?? ???&? ?MathType??
????u?th??????aea K – eiao?oe??io, ui aeaco?, yea /anoeia nooiaeeeey
?icaeia/a ci?uo?oueny iaae noaeiaii;

R – na?aaei?e ?aae?on e?eaecie iioeei? noaeiaiai? iiaa?oi?;

– eoo caeiaiiy, ae?aaeaiee o ?aae?aiao.

Eiao?oe??io E aoei i?eeiyoi ??aiei iaeeieoe? aeey i’ynoeiai-oaeaiaiaiai
noaeiaa ? 0,5 aeey i?aeoaeaiaiaeo noaeia?a. Na?aaei? cia/aiiy ?aae?on?a
R, caeiaoo? iaoiaeii inoaiiao??? ia e?noeiaeo i?aia?aoao, na?aaei?
cia/aiiy iaeneiaeueieo eoo?a caeiaiiy ? R aaee/eie aeneo?n?? (oaae. 1).

Oaaeeoey 1

Na?aaei? cia/aiiy ?aae?on?a i’ynoeiaeo e?noie oa aie?aie oaeaia
iaeueoe?a, na?aaei? cia/aiiy iaeneiaeueieo eoo?a caeiaiiy ? R aaee/eie
aeneo?n??.

NoaeiaR, niwmetafile8? ???????????????
???????????yyy????.????1?????? ???????
 `???&??yyyy?????Ayyy*??? ??E?? ???&?
?MathType??P????u?th??????Ioaea, i?e iiaiiio caeiaii? an?o noaeia?a
o?ueiooaeaiaiaiai iaeueoey, caaaeueia aeneo?n?y ?icaeia/a neeaaea 1,4 –
1,5 ni, ye ? ?acoeueoaoe aiaoii?/ieo aei??thaaiue.

Coneeey aeiaaiai ?icaeia/a iaea?eueo aoaeoeaia a ?icaeiaii? ION. Ia IION
eiai ae?y ia?aaea?oueny o?eueee /anoeiai ? iaeaea ia ia?aaea?oueny ia
AeION. A ?icaeiaii? i?aeoaeaiaiaeo noaeia?a aaaeeeao ?ieue a?ae?a?athoue
aeani? i’yce eeno?, coneeey yeeo /anoeiai ia?aaeathoueny /a?ac
eaoa?aeuei? io/ee nooiaeeeueii-aiiiaa?ioe/iiai ?icoyaiaiiy ?icaeia/a.

Aeieoaaiiy nooiaeeeey aeiaaiai ?icaeia/a i?iyaey?oueny a ia?oo /a?ao a
?icaeoeo ?icaeiaeueii? eiio?aeoo?e ION, iia??oo?oueny caeiaiiy IION ? ia
iaiaaeo?oueny caeiaiiy AeION.

Aiae?coth/e iiaeeea? i?e/eie aeieeiaiiy ?icaeiaeueieo eiio?aeoo?
i?e ia?aeiiao i’ynoeiaeo e?noie, a?aei?oeee niaoeeo?/i?noue ae?? aeanieo
i’yc?a eeno? (mm.lumbricales et interossei) ia caeiaiiy iaeueoe?a. ?o
noia?ia ae?y Fli ae?? caeiaeueii ia i’ynoeiai-oaeaiaia? noaeiae oa
?icaeiaeueii ia i?aeoaeaiaia?. I?e aeoeaaoe?? aeanieo i’yc?a eeno?
caeiaiiy iaeueoe?a i?ioiaeeoue ii aaeee?e aeoc? – caeiaiiy
i’ynoeiai-oaeaiaiaeo noaeia?a c? noaa?e?caoe??th i?aeoaeaiaiaeo a
iieiaeaii? ?icaeiaiiy (?en.1a). Oiaoi aeani? i’yce caaacia/othoue
ii/aoeiao oaco caeiaiiy iaeueoe?a. Oea ni?aa?aeiioaiiy ooieoe?? aeanieo
i’yc?a iiaeooue ii?oooaaoenue i?e aeaoi?iaoe?? oa ii?ooaii? in?
i’ynoeiai? e?noee aiane?aeie ?? ia?aeiio. Aoaeoeai?noue caeiaiiy i’yc?a
cieaeo?oueny ca ?aooiie ciaioaiiy iea/a neee a?aeiinii in? I1 ION, a i?e
cia/iiio ci?uaii? aie?aee, i’yc ii/eia? ae?yoe ye ?icaeia/ (?en.1a). A
oeueiio aeiaaeeo cae/ia aeoeaaoe?y i’yc?a o?eueee ni?ey? oi?ioaaiith
?icaeiaeueii? eiio?aeoo?e. Caeiaeueiee aeo ooai?th?oueny a?aeiinii oi/ee
ia?aeiio A, ? yeui iaia c?iuaiiy, aeo caeiaiiy aoaea i?ioiaeeoe ia a
noaeia? (I1), a a i?noe? ia?aeiio (A).

?en.1. Noaia ae?? aeanieo i’yc?a eeno? ia noaeiae iaeueoey a ii?i? oa
i?e ia?aeii? i’ynoeiai? e?noee.

I?e eiina?aaoeaiiio e?eoaaii? ia?aeii?a i’ynoeiaeo e?noie, aac onoiaiiy
aeaoi?iaoe??, o?eaaea a?aenooi?noue ?oo?a o i’ynoeiai-oaeaiaiaiio
noaeia? ? aeiaeaoeiaei ?iiia?e?caoe?eiei oaeoi?ii oi?ioaaiiy
eiio?aeoo?e. I?iaaaeaiee aiae?c aeicaiey? ae?iaeoe ianooiiee e?eoa??e
aeey i?iaiicoaaiiy ?icaeoeo eiio?aeoo?e: yeui a ?acoeueoao? ia?aeiio
aie?aea i’ynoeiai? e?noee ci?noeeanue iano?eueee, ui ?? oeaio? aeeoia ca
iaae? oiiaiiai i?iaeiaaeaiiy ae?ao?co, oi ?icaeoie eiio?aeoo?e iiaeeeaee
(ia ?en.1a, aeacaia ci?uaiiy iicia/aia a?ae??ceii D).

Aeey aecia/aiiy aieeao eooiai? aeaoi?iaoe?? e?noie ia?aaeie?//y ia
?icaeoie ?icaeiaeueieo eiio?aeoo? o ION, ?ic?iaeee iaoaiaoe/io iiaeaeue
i?eionoeaoe oaea:

1. Aio?iiiiao?e/ia aeiaaeeia e?noee i?e ooai?aii? «ai?aa» ia
ci?ith?oueny.

2. I’yc iaoiaeeoue e?noeo ii iaea?eueo aeiaaiio oeyoo, oiaoi /a?ac
aa?oeio «ai?aa».

?ic?aooiie, ca oaeeo oiia aeicaiey? io?eiaoe ioe?ieo «iaea??oiai
aeiaaeeo», oiaoi iaea?eueoiai ?icoyaiaiiy i’yca, coiiaeaiiai
ooai?aiiyi ai?aa.

?icaeyiaii aeaa aeiaaeee: ia?aeii a na?aaei?e o?aoei? e?noee (?en.2a) ?
a aeenoaeuei?e o?aoei? (?en.2a). Iicia/eii: A,A – e?ioe? ceaiaii?
e?noee; N – oi/ea ia?aeiio; L – aio?iiiiao?e/ia aeiaaeeia e?noee a
ii?i?; wmetafile8? ???????????????
???????????yyy????.????1?????? ???????
`????&??yyyy?????Ayyy*???@????? ???&?
?MathType??0????u?th??????wmetafile8? ???????????????
???????????yyy????.????1?????? ???????
 ????&??yyyy?????AyyyEyyy@??j?? ???&? ?MathType??
????u?th??????wmetafile8? ???????????????
???????????yyy????.????1?????? ???????
 ????&??yyyy?????AyyyEyyy@??j?? ???&? ?MathType??
????u?th??????

?en.2. Noaiaoe/ia aeaoi?iaoe?y ia?aaeie?//y i?e ia?aeii? a na?aaei?e oa
aeenoaeuei?e /anoei?.

Aeey noaie (?en.2-a) ae?ac ia? neeaaei?oee aeaeyae:

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???????????yyy????.????1?????? ???????
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????u?th??????Iaea?eueoa iiaeiaaeaiiy ia? i’yc i?e ia?aeii? a
na?aaei?e oi/oe?, iaeiae aeenoaeueia ci?uaiiy oi/ee ia?aeiio i?i?iaeueii
aieeaa? ia ciaioaiiy iiaeiaaeaiiy. Aaniethoi? aaee/eie iiaeiaaeaiiy
noathoue nooo?aeie i?e eooao wmetafile8? ???????????????
???????????yyy????.????1?????? ???????
`????&??yyyy?????Ayyy*???@????? ???&?
?MathType??0????u?th??????Oaaeeoey 2

?ic?aooiee aaniethoieo iiaeiaaeaiue wmetafile8? ???????????????
???????????yyy????.????1?????? ???????
 ????&??yyyy?????AyyyEyyy@??j?? ???&? ?MathType??
????u?th??????wmetafile8? ???????????????
???????????yyy????.????1?????? ???????
`????&??yyyy?????Ayyy*???@????? ???&?
?MathType??0????u?th???????en.3. Eiao?oe??io iiaeiaaeaiiy i’yca a
caeaaeiino? a?ae eooa e?noeiai? aeaoi?iaoe??

Ioaea, eooia? aeaoi?iaoe?? e?noie aei 10° nooo?ai ia aieeaathoue ia
ooieoe?th i’yc?a, ye? iiaeiaaeothoueny a ?acoeueoao? aeaoi?iaoe??.
Iiaeaeueoa ca?eueoaiiy eooa aeaoi?iaoe?? i?ecaiaeeoue aei ??ceiai
ia?inoaiiy iaiaaeaiiy aeneo?n?? i’yca.

Aeey ioe?iee ?ioaineaiino? i?ioeano o?a?icoaaiiy, ye iiaeeeai? i?e/eie
oi?ioaaiiy eiio?aeoo?, a?io?i?/ii aeine?aeaeoaaee e?ia 25-oe oai?eo ?c
?EION ? aeyaeee ii?ooaiiy iai?io eieaaaio, ui i?iyaeyeinue ia?aaaaeaiiyi
i?ioean?a a?ineioaco iaae eaoaaie?ciii. A?io?i?/ii ?aaeoeaiee o?a?ic
oa?aeoa?eco?oueny ii?ooaiiyi ??aiiaaae i?ae neioacii oa ?iciaaeii
eieaaaio a a?e ia?aaaaeaiiy neioaco. Oea i?iyaeyeinue aenieei ai?noii
a?eeiaica’ycaiiai ienei?ie?io ia oii? cieaeaieo, ii??aiyii c ii?iith,
cia/aiue iaioeaeiica’ycaiiai oa a?eueiiai ienei?ie?io ? iecueeith
aeoeai?noth eieaaaiie?oe/ieo oa?iaio?a (eaoainei A ? eieaaaiaca). ??ci?
iieacieee oiiiaiai cia/aiiy oa?iaio?a, ui a?aeia?aaeathoue iai?i
eieaaaio oa ?ioaineai?noue i?ioeano o?a?icoaaiiy iieeaaeaii a iniiao
?iciiae?eo ianoaaeaieo oai?eo ia aea? a?oie. Aei ia?oi? a?oie oa?eoee 11
oai?eo c? ca?eueoaiei o 2,8 ?ace iiiaae ii?io ai?noii a?eeiaica’ycaiiai
ienei?ie?io, ? cieaeaiei, ii??aiyii c ii?iith, ai?noii
iaioeaeiica’ycaiiai, a?eueiiai ienei?ie?io oa eieaaaiie?oe/iith
aeoeai?noth oa?iaio?a eaoaineio A ? eieaaaiace. Ae?oaa a?oia (14 oai?eo)
iaea a?eueo? iieacieeaie eiioeaio?aoe?? a?eeiaica’ycaiiai ienei?ie?io (o
4,3 ?ace aeua ii?ie) o ii??aiyii? c ia?oith a?oiith. Noiniaii ?ioeo
iieaciee?a (iaioeaeiica’ycaiee ? a?eueiee ienei?ie?i, eieaaaiie?oe/ia
aeoeai?noue eaoaineio A oa eieaaaiace) o oai?eo ae?oai? a?oie iaea
cia/ia a?aeoeeaiiy ?o a?ae ii?ie (a?aeiia?aeii o 1,5; 1,4; 1,3; 1,6
?ace) a ii??aiyii? c iaoe??ioaie ia?oi? a?oie.

Aiae?c a?io?i?/ieo ?acoeueoao?a iieacaa, ui a iniia? oi?ioaaiiy ?EION
eaaeaoue i?ioeane o?a?icoaaiiy, eio?? ni?e/eiythoue ii?ooaiiy
iaoaaie?cio eieaaaio. I?e oeueiio ci?ith?oueny ni?yiiaai?noue oa
?ioaineai?noue i?ioean?a a?ineioaco ? ?iciaaeo eieaaaio, ui i?ecaiaeeoue
aei iaoieia?/iiai ii?ooaiiy ni?aa?aeiioaiue i?ae ieie. Ii/aoeiaee
iaoaaie?/iee oii o eiaei?e a?oi? oai?eo ia? i?iaiinoe/ia cia/aiiy i?e
ieaioaaii? oaeoeee ? oaoi?ee iia?aoeaiiai e?eoaaiiy oa io?eiaiiy
iiceoeaieo ooieoe?iiaeueieo ?acoeueoao?a. E?eoe/iei, aai aecia/aeueiei
iai?aaeai?noue iiaeaeueoeo ?aia?aoeaieo i?ioean?a, ui aeieeathoue a cii?
iia?aoeaiiai ao?o/aiiy, ? ca iaoeie aeaieie no?ie o 2 – 4 i?n i?ney
iia?aoe??. Naia a oeae ia??iae i?iyaeythoueny oaiaeaioe?? aai aei
ii?iae?caoe?? ni?aa?aeiioaiue i?ae i?ioeanaie a?ineioaco oa ?iciaaeo
eieaaaio (oai?? ia?oi? a?oie), aai aei iiaeaeueoiai c?inoaiiy ii?ooaiiy
oeeo i?ioean?a (oai?? ae?oai? a?oie). Aeyaeai? ci?ie a?io?i?/ieo
iieaciee?a niaoeeo?/ii a?aeia?aaeathoue ?ioaineai?noue iaoieia?/ieo
i?ioean?a, ui aeieeathoue o niieo/i?e oeaiei?, ca ?o iieacieeaie
ioe?ith?ii aoaeoeai?noue ia?aaoaeiae o i?e a iane?aeie e?eoaaiiy.

Neeaaeiee neiioiiieiiieaen iaoai?/ieo oa oa?i?/ieo ooeiaeaeaiue eeno?
coiiaea cia/io e?euee?noue eeaneo?eaoe?e eiio?aeoo?. Aea aei oeueiai
/ano, ia aoei ?ic?iaeaii noaie iaoiaaiaco oa eeaneo?eaoe?? ?icaeiaeueieo
eiio?aeoo? (?en.4, ?en.5). Aeoiaey/e c aeanieo aeine?aeaeaiue,
anoaiiaeee, ui i?i?iaeuei? caoaaoe eeno? iiaeeea? o?eueee i?e caeiaii?
oaeaia aei eooa 30°, a ?icaeiaeuei? eiio?aeoo?e ION i?e ?ooao 20°–0–60°,
ye i?aaeei, iio?aaothoue o?eueee eiina?aaoeaiiai e?eoaaiiy. Neeaaei?noue
a?aeiiaeaiiy ooieoe?? eeno? oa e?euee?noue aoai?a e?eoaaiiy caeaaeaoue
a?ae eieae?caoe?? o?aaie, e?eueeino? ? oyaeeino? o?aaiiaaieo
ooieoe?iiaeueieo no?oeoo?.

?en.4. Noaia iaoiaaiaco ?icaeiaeueieo eiio?aeoo? i’ynoeiai-oaeaiaiaeo
noaeia?a.

?en.5. Eeaneo?eaoe?y ?icaeiaeueieo eiio?aeoo? i’ynoeiai-oaeaiaiaeo
noaeia?a.

A?aeiiaia e?eoaaiiy ia?aaaaeii? a?eueoino? oai?eo iio?aaoaaei /eneaiieo
?aeiino?oeoeaii-a?aeiiaieo iia?aoe?e. Ca iaeei aoai a?aeiiaeaiiy an?o
ooeiaeaeaieo no?oeoo? oa a?aeiiaeaiiy ooieoe?? aoei iaiiaeeeaa. A?aeoae
e?ioeaaee ?acoeueoao o?eaaeiai e?eoaaiiy caeaaeaa a?ae i?aaeeueiino?
aeai?o oaeoeee e?eoaaiiy, ii/a?aiaino? aoai?a ?aeiino?oeoeaieo
ao?o/aiue, no?ie?a i?ae iia?aoe?yie, aaeaeaaoiino? i?neyiia?aoe?eii?
?aaa?e?oaoe??, a?aooaaiiy caaaeueiiai noaio i?aai?cio.

O oai?eo ia?oi? a?oie ia?oi/a?aiai a?aeiiaethaaee aiaoii?/io oe?e?noue ?
aca?iia?aeiioaiiy ooeiaeaeaieo e?noie ia?aaeie?//y oa eeno? oeyoii
inoaineioaco, a, i?e iaiao?aeiino? aeeiioaaee a?eueio e?noeiao ieanoeeo.
I?e iinoo?aaiaoe/ieo aeano?oeoe?yo noaeia?a aeeiioaaee ?acaeoe?eio
a?o?iieanoeeo oa i?e?iiae?inoaeeiio ia?anaaeeo iethnia-oaeaiaiaiai
noaeiaa ae?oaiai iaeueoey noiie a iieiaeaiiy i’ynoeiai-oaeaiaiaiai.
Iaeaaeio oaaao i?eae?eyee onoiaiith eooiaeo aeaoi?iaoe?e oa aiaoii?/iiio
aca?iia?aeiioaiith e?noie. Ae?oaei aoaiii e?eoaaiiy a?aeiiaethaaee
ianeai? ?ooe a i’ynoeiai-oaeaiaiaeo noaeiaao, ui aaaaeaee eeth/iaei
iiiaioii iaoiai iaoiaeo i?e onoiaii? ?icaeiaeueieo eiio?aeoo? ??ciiai
aaiaco. Ie ?ic?iaeee iaoiae onoiaiiy eiio?aeoo? c aeiiiiiaith
iia?e?coth/i? iia?aoe??; ca iniiao acyee iia?aoe?th J. Manninger [Jesse
B., 1991]. Iniaeeaino? iia?aoe?? iieyaathoue o aeei?enoaii?
cai?iiiiiaaiiai oa caiaoaioiaaiiai iaie i?eno?ith aeey iia?e?caoe?? ION
(Iaoaio Oe?a?ie ?151 «UA», A61 A17/58. I?eno??e aeey a?o?ie?co
i’ynii-oaeaiaiaeo noaeia?a eeno? / No?aooi N.N., Aaeiae/ A.A. (Oe?a?ia);
?94021925), c aeiiiiiaith yeiai ie iia?e?coaaee noaeia, a?aeae?eyee
c?iuaio aeieiiio ieanoeieo noaeiaa a?ae aie?aee i’ynoeiai? e?noee c
oeeueiiai aeinooio. Ca?eueiyee a?ae ?oaoeaaeo c?iuaiue nooiaeeeey
?icaeia/?a, ?icaeiaeueiee aiiiaa?ic, i’yce eeno?. Aaeeea cia/aiiy
iaaeaaaee i?neyiia?aoe?ei?e ?aaa?e?oaoe??. A caeaaeiino? a?ae
aioo??oiueinoaeiaiaeo oa ia?aa?oeeoey?ieo ci?i, aeei?enoiaoaaee
aeeiai?/ia oeioaaiiy aia?aoii ciai?oiuei? o?enaoe??, iicanoaeiaiao
?iiia?e?caoe?th oieoeyie o i?iaeiaae 10 – 15 aei?a aai ianeaio ?ic?iaeo
?oo?a o noaeia?, ii/eiath/e c 2 – 3-ai aeiy i?ney iia?aoe??.

Aeenaaeain i’yc?a ia ia?aaeie?//? oa eeno? o oai?eo ae?oai? a?oie
niiioeaa ian aei ia?oi/a?aiaiai a?aeiiaeaiiy oe?eino? ia?a?a, o oai?eo c
?o ooeiaeaeaiiyi c iaeyaeo ia no?iee o?aaie. Iia?e?caoe?y noaeia?a ia?
ia?aaeoaaoe ieanoeoe? oa a?aeiiaeaiith nooiaeeeue, ine?eueee a?aeiiaeaia
nooiaeeeey ia iiaea ia?aneeeoe ii?? eiio?aaiaaieo noaeia?a.
Caaeia?eueiee ianeaiee ianya ?oo?a o noaeiaao iaeueoe?a ? iaei??th c
iniiaieo ia?aaeoiia ieanoeee nooiaeeeue. A?aeiiaethaaee oe?e?noue
nooiaeeeue caeia/?a oeyoii aeaiaoaiii? ieanoeee i?e ooeiaeaeaiiyo o
e?eoe/i?e cii?, coeaaiiyi aai iinoiaeaeiith ieanoeeith i?e ooeiaeaeaii?
o 3 – 4-?e cii?. Ia?ae a?aeiiaethaaee ieanoeeith iae?io?ainieaioaoii
eeoeiaiai ia?aa. I?e a?aenooiino? aeoeaiiai caeiaiiy a ION aeeiioaaee
o?ainiiceoe?th i’yc?a.

A?aenooi?noue caei?iaiai oe??iiai iie?iao ia oeeuei?e iiaa?oi? eeno? oa
ia?aaeie?//y a ii?aeiaii? c ?EION o oai?eo o?aouei? a?oie iio?aaoaaei
iniaeeai? iia?aoeaii? oaoi?ee ? oaeoeee c-ca aiaoiii-ooieoe?iiaeueii?
iniaeeaino? ciie. O?aaeeoe?eia a?eueia oe??ia ieanoeea ooo iaaei?a/ia
/a?ac oa, ui a?eueiee iiaiioa?iaee aea?iio?ainieaioao c?iuo?oueny c
?aoeei??ioiith ae?eyieith, oei naiei aeieoth/e aeneo?n?th nooiaeeeue
?icaeia/?a, oi?ioth/e eiio?aeoo?o. Oe??i? eeaio? ia noaeeiieo i?aeeao, c
aaoiiiiiei aeeaeaiiyi o oaeeo aeiaaeeao ? iaoiaeii aeai?o aeey onoiaiiy
eiio?aeoo? oeueiai aaiaco. Aea?iio?ainieaioaoe, ye? ie aeei?enoiaoaaee,
aoee: ?ioaoe?eiee i?iiaiaaee eeaiioue, i?iiaiaaee eeaiioue ia
i?ieneiaeuei?e noaeeii?e i?aeoe? ?c caei?iaiai ia?aaeie?//y,
oi?aeiaei?caeueiee eeaiioue, oeeueiee eeaiioue noiie, iaoaeiiee
eeaiioue. Oni?oi?noue iia?e?coth/eo iia?aoe?e o ae?oaiio aoai?, coiiaeea
iiaeeea?noue a?aeiiaeaiiy caoaao?a i?ney ieanoeee aai oaiie?co
nooiaeeeue ?icaeia/?a o o?aoueiio aoai?.

Iaeaaae/ith eaoaai???th oai?eo aoea /aoaa?oa a?oia, aea oai?? iaee
ii?aeiai? o?aaie ??cieo ooieoe?iiaeueieo no?oeoo?. Oae? o?aaie
iio?aaoaaee ?iaeea?aeoaeueiiai i?aeoiaeo aei e?eoaaiiy c a?aooaaiiyi
oaeoe/ieo i?eioeei?a oa ii?aeiaiiyi a iaeiiio aoai? a?aeiiaeaiiy
iaeneiaeueii? e?eueeino? o?aaiiaaieo no?oeoo?.

Oaeoe/i? i?eioeeie e?eoaaiiy oe??? eaoaai??? oai?eo ie noi?ioethaaee
oae:

1. Iaeneiaeueii ?aii?e ii/aoie e?eoaaiiy c iiiaioo o?aaie;

2. Ei?ioeee, aea aoaeoeaiee ia?aaeiia?aoe?eiee ia??iae eiina?aaoeaiiai
e?eoaaiiy;

3. I?aeaioia/? iia?aoeai? ao?o/aiiy ni?yiiaai? ia:

— a?aeiiaeaiiy noaa?eueiino? noaeia?a ? neaeaoo ia?aaeie?//y oa eeno?;

— iiaia cae?eooy aeaoaeoo iiaiioe?iiei oe??iei iie?eaii.

4. Iniiai? ?aeiino?oeoeaii-a?aeiiai? ao?o/aiiy, yeeie aeinyaaee:

— a?aeiiaeaiiy aiaoii?/ieo aca?iia?aeiioaiue ooieoe?iiaeueieo no?oeoo?;

— a?aeiiaeaiiy ianeaii? ?ooeeaino? noaeia?a;

— a?aeiiaeaiiy ooieoe?? i’yc?a-aeaeaoi?a;

— a?aeiiaeaiiy aaeaino i’yc?a.

5. I?ney eiaeiiai iia?aoeaiiai ao?o/aiiy iaiao?aeia i?neyiia?aoe?eia
?aaa?e?oaoe?y o i?iaeiaae 2,5 – 4-o i?n.

Ia iniia? aiae?co e?eoaaiiy oeeo oai?eo, ie ae?iaeee oae? ianyae oa
iaoiaee aoai?a ? aeiiae aei aecia/aiiy ?o ii/a?aiaino?:

— i?e aeaoaeoao oe??e oa ?ioeo no?oeoo?, cai?uaiiy aeaoaeoo oe??e ne?ae
i?iaiaeeoe a ia?oiio aoai?, yeui aac oe??? iia?aoe?? iaiiaeeea? ?io?
iia?aoeai? ao?o/aiiy. sse i?aaeei, ne?ae aeei?enoiaoaaoe eiia?iiaai?
eeaio? aeey iaeii/aniiai cai?uaiiy aeaoaeo?a e?eueeio no?oeoo?;

— i?e ianoaa?eueiino? neaeaoa, inoaineioac aeeiioaaoe a ia?oiio aoai?,
i?e oeueiio ?ieiee aeioe?eueiei ? aei?i/aiiy naaiaioa;

— a aoai? oe??ii? ieanoeee oa inoaineioaco aeioe?eueii a?aeiiaethaaoe e
?io? aiaoii?/i? no?oeoo?e;

— ii/a?aia?noue aoai?a aecia/a?oueny ?c a?aooaaiiyi eieae?caoe??,
aeaaiino? o?aaie, ui iniaeeai aeooaeueii i?e ooeiaeaeaii? ia?a?a. O
oeueiio aeiaaeeo ia?ae iaiao?aeii a?aeiiaeoe yeiiiaa ?ai?oa.
A?aoiaothoueny aeiiae aei ianyao aoaio ? iaiao?aei?noue oe??ii? oa
e?noeiai? ieanoeee;

— i?e ieaioaaii? ianyao oa ii/a?aiaino? aoai?a o??o?a?/iiai e?eoaaiiy
iaiao?aeii a?aoiaoaaoe iniaeeaino? o?aaie oa ?? iane?aeee, i?ioan?eio
i???ioaoe?th oai?iai oa eiai ?iaeea?aeoaeueieo iniaeeainoae – aioiaiino?
i?iaanoe eo?n ?aaeeeaeueiiai e?eoaaiiy aai iaiaaeeoenue a?aeiiaeaiiyi
iaei??? ooieoe?? /e aeiiiaoeny iaaiiai einiaoe/iiai aoaeoo.

?acoeueoaoe e?eoaaiiy ia?iaeee ia ia?niiaeueiiio eiii’thoa?? ca
aaeineiiaeaiei iaie iaoiaeii Aia?eeainueei? anioe?aoe?? o??o?a?a eeno?.
Anoaiiaeee, ui na?aaei? iieacieee ooieoe?? eeno? (caoaaoe, /ooeea?noue,
noia?i? aeoeai? ?ooe noaeia?a e?ioe?aee, eeno? oa iaeueoe?a, iiiceoe?y
ia?oiai iaeueoey, oiui) a eiaei?e a?oi? aoa ??ciee ? caeaaeaa a?ae
aaaeeino? o?aaie oa ae?aaeaiino? eiio?aeoo?. O ia?o?e a?oi? oai?eo
ooieoe?y eeno? iie?aueeanue c 56,05%+1% aei 81,31%+2%, o ae?oai? a?oie –
c 34,96%+1% aei 65,72%+1%, o o?aouei? a?oie – c 44,95%+2% aei 81,97%+3%,
o /aoaa?oi? a?oie – c 44,95%+2% aei 68,09%+2%.

AENIIAEE

1. A?aeiiaeaiiy ooieoe?? eeno? o oai?eo c ?icaeiaeueieie eiio?aeoo?aie
i’ynoeiai-oaeaiaiaeo noaeia?a iio?aao? aeeoa?aioe?eiaaiiai i?aeoiaeo aei
e?eoaaiiy oai?eo ?c a?aooaaiiyi ao?iiaoiaaiaoe/ieo iaoai?ci?a oi?ioaaiiy
eiio?aeoo? ? oyaeeino? o?aaie.

2. Ii?ooaiiy iai?io eieaaaio ? iaei??th c ia?aaeoiia oi?ioaaiiy
eiio?aeoo? i?ney o?aai eeno? oa e?ioe?aee a oe?eiio.

3. Ii/aoeiaee iaoaaie?/iee oii o oai?eo ?c ?icaeiaeueieie eiio?aeoo?aie
i’ynoeiai-oaeaiaiaeo noaeia?a ia? cia/aiiy i?e ieaioaaii? iia?aoeaiiai
e?eoaaiiy ? ? aaaeeeaith i?iaiinoe/iith iciaeith i?e aeai?? o??o?a?/ii?
oaeoeee.

4. A?iiaoai?/ia iiaeaeue ?oo?a o noaeiaao eeno? oa iaeueoe?a ?
aaaeeeaei i???ioe?ii o ieaioaaii? oaeoeee iia?aoe?? ii a?aeiiaeaiith
ooieoe?? i?e ia?aeiiao e?noie oa ooeiaeaeaiiyo nooiaeeeue ?icaeia/?a ?
aeicaiey? ?ic?aooaaoe iieacaiiy aei iia?aoe?? oa i?e iaiao?aeiino?
aaee/eio iiaeiaaeaiiy nooiaeeeue.

5. ?ic?iaeaia iaie iia?aoe?y iia?e?caoe?? i’ynoeiai-oaeaiaiaeo noaeia?a
aea? ciiao a?aeiiaeoe ianeaio ?ooeea?noue o noaeiaao iacaeaaeii a?ae
ao?iiaoiaaiaoe/ieo oaeoi??a oi?ioaaiiy ?icaeiaeueieo eiio?aeoo?
i’ynoeiai-oaeaiaiaeo noaeia?a.

6. Noaa?euei?noue e?noeiaiai ea?eano ia?aaeie?//y oa eeno? ?
iaiao?aeiith ia?aaeoiiaith a?aeiiaeaiiy ooieoe?? eeno? o oai?eo ?c
?icaeiaeueieie eiio?aeoo?aie i’ynoeiai-oaeaiaiaeo noaeia?a.

7. I?e ?icaeiaeueieo eiio?aeoo?ao i’ynoeiai-oaeaiaiaeo noaeia?a o
ii?aeiaii? c ?oaoeaaith aeaoi?iaoe??th oe??e oeeo eeno? oa ia?aaeie?//y,
o?eueee ieanoeea oe??e iiaiioe?iiei oe??ii-oanoe?aeueiei eeaioai ia
noaeeii?e i?aeoe? aea? ciiao a?aeiiaeoe ooieoe?th ? caiia?aoe ?aoeeaeeao
eiio?aeoo?e.

8. I?io?eaeoeea eiio?aeoo? caeeoa?oueny aaaeeeaith oiiaith oni?oiiai
e?eoaaiiy oai?eo ?c o?aaiaie eeno? a a?aeiiaeaiiy ooieoe?? eeno? i?e
iayaiino? ?icaeiaeueieo eiio?aeoo? i’ynoeiai-oaeaiaiaeo noaeia?a ?
neeaaeiei aaaaoiaoaiiei ?aeiino?oeoeaiei ao?o/aiiyi ? eiai ne?ae
i?iaiaeeoe o niaoe?ae?ciaaieo e?eoaaeueieo caeeaaeao.

9. Ai?iaaaeaeaiiy cai?iiiiiaaii? nenoaie i?io?eaeoeee, e?eoaaiiy oa
i?neyiia?aoe?eii? ?aaa?e?oaoe?? oai?eo ?c ?icaeiaeueieie eiio?aeoo?aie
i’ynoeiai-oaeaiaiaeo noaeia?a aeicaiey? iie?aueoe ?acoeueoaoe e?eoaaiiy
a na?aaeiueiio ia 30% oa cia/ii cieceoe ??aaiue ?iaae?aeiino? oai?eo.

Nienie ?ia?o, iioae?eiaaieo ca oaiith aeena?oaoe??

1. Aaeiae/ A.A., Ai/ae I.E., Ia?o?eiaa O.I. Aieea ii?ooaiue iai?io
eieaaaio ia ?acoeueoaoe e?eoaaiiy oai?eo c iane?aeeaie o?aai aa?oiuei?
e?ioe?aee. // Iaoeiaee a?niee Oaeai?iaenueeiai oi?aa?neoaoo. – na??y
Iaaeeoeeia, aeione ?7. – Oaeai?iae, 1999. – N. 201–205.

2. Oeeiaaethe A.?., Aaeiae/ A.A., No?aooi N.N., Naiii I.A. E?eoaaiiy
canoa??eeo iioeiaeaeaiue e?eoueiaiai oa na?aaeeiiiai ia?a?a,
oneeaaeiaieo ?icaeiaeueieie eiio?aeoo?aie i’ynoeiai-oaeaiaiaeo noaeia?a
// Atheaoaiue Oe?.Anioe?aoe?? iae?io??o?a?a. – 1998. – ?7. – N. 67–69.

3. Aaeiae/ A.A. Iaoiaee a?aeiiaeaiiy ooieoe?? eeno? o oai?eo c
iane?aeeaie o?aai aa?oiuei? e?ioe?aee, oneeaaeiaieo ?icaeiaeueieie
eiio?aeoo?aie i’ynoii-oaeaiaiaeo noaeia?a // Iaoeiaee a?niee
Oaeai?iaenueeiai oi?aa?neoaoo. – na??y Iaaeeoeeia, aeione ?5. –
Oaeai?iae, 1998. – N. 41–44.

4. Iaoaio Oe?a?ie ?151 «UA», A61 A17/58. I?eno??e aeey a?o?ie?co
i’ynii-oaeaiaiaeo noaeia?a eeno? / No?aooi N.N., Aaeiae/ A.A. (Oe?a?ia);
?94021925; Cayae.16.02.94; Iioae.30.04.98?.:»I?iieneiaa aeani?noue»,
1998, Athe. ?2. – N. 3.2.?.

5. No?aooi N.N., Nieiethe I.I., Aaeiae/ A.A. Aecia/aiiy oaeoeee
e?eoaaiiy oai?eo c o?aaiith iea/iaiai nieaoaiiy ca aeiiiiiaith
aeaeo?ii?ia?ao?? // I?oiiaaeey o?aaiaoieiaey e i?ioace?iaaiea. – 1997. –
?3. – N. 103.

6. No?aooi N.N., Aaeiae/ A.A. O??o?a?/ia e?eoaaiiy ?icaeiaeueieo
eiio?aeoo? i’ynoii-oaeaiaiaeo noaeia?a o oai?eo c iane?aeeaie o?aai
eeno? // Iao.aeiee.iao/ii-i?aeo.eiio. «Nia?aiaiiua aniaeou ea/aiey o?aai
eenoe e eo iineaaenoaee». – Aeiai?iiao?iane. – 1998. – N. 95–96.

7. No?aooi N.N., Nieiethe I.I., Aaeiae/ A.A. Aeaeo?ii?ia?ao?y o
aecia/aii? oaeoeee e?eoaaiiy oai?eo c o?aaiith iea/iaiai nieaoaiiy //
Iao.eiio. «Aeieia?y oa noai caei?ia’y ianaeaiiy a no/anieo oiiaao». –
Oaeai?iae,– 1996. – N. 148–149.

8. Aaeiae/ A.A., Ae?the I.I. E?eoaaiiy ?icaeiaeueieo eiio?aeoo?
i’ynoeiai-oaeaiaiaeo noaeia?a o oai?eo c canoa??eei iioeiaeaeaiiyi
nooiaeeeue caeia/?a iaeueoe?a eeno? // Iaoa??aee i?ae?inoeooonueei?
iaoe.-i?aeo. eiio. iieiaeeo a/aieo oa oao?aoe?a i.Ee?aa c aeooaeueieo
ieoaiue o?aaiaoieia??, i?oiiaae?? oa noi?aeieo aeenoeeie?i. – Ee?a,
1995. – N. 9–11.

9. Iniaeeaino? e?eoaaiiy ?icaeiaeueieo eiio?aeoo? i’ynoeiai-oaeaiaiaeo
noaeia?a o oai?eo c ?oai?/iei ooeiaeaeaiiyi i’yc?a ia?aaeie?//y oa eeno?
oa o?aaiaie ia?eoa?e/ieo ia?a?a / No?aooi N.N., Aaeiae/ A.I., Aaeiae/
A.A., Ae?the I.I. / Aeooaeuei? ieoaiiy a?ieia?? iii?ii-?ooiaiai aia?aoo:
Iaoa??aee VIII oeiee e?a?i NIAe. – Ee?a, 1996. – N. 21–21.

10. Aaeiae/ A.A., Ae?the I.I., Eo??iiee ?.I. Aeei?enoaiiy
i?e?io??o?a?/ii? oaoi?ee a e?eoaaii? ?icaeiaeueieo eiio?aeoo?
i’ynoei-oaeaiaiaeo noaeia?a // XII c’?cae o?aaiaoieia?a-i?oiiaae?a
Oe?a?ie: Iaoa??aee c’?caeo. – Ee?a, 1996. – N. 311–312.

11. No?aooi N.N., I.I Eo??iiee, Aaeiae/ A.A. O??o?a?/ia e?eoaaiiy
canoa??ei? ii?aeiaii? o?aaie ia?aiaeo noiaao??a ia ia?aaeie?//? oa
cai`ynoeo //XII c’?cae o?aaiaoieia?a-i?oiiaae?a Oe?a?ie: Iaoa??aee
c’?caeo. – Ee?a, 1996. – N. 321–323.

12. Aaeiae/ A.A. E?eoaaiiy ?icaeiaeueieo eiio?aeoo? i’ynoeiai-oaeaiaiaeo
noaeia?a ia oii? aeenaaeaino i`yc?a // I?eei?aeiii? a?enueea Oe?a?ie,
oeaio?aeueiee a?enueeiaee aini?oaeue: Ca. iaoe.-i?aeo. ?ia?o, i?enay/.
5-e ??/ieoe? i?eei?aeiiieo a?enuee Oe?a?ie. – Ee?a, 1996. – N. 35–37.

AIIOAOe?ss

Aaeiae/ A.A. O??o?a?/ia e?eoaaiiy ?icaeiaeueieo eiio?aeoo?
i’ynoeiai-oaeaiaiaeo noaeia?a o oai?eo c iane?aeeaie o?aai aa?oiuei?
e?ioe?aee. – ?oeiien. Aeena?oaoe?y ia caeiaoooy iaoeiaiai nooiaiy
eaiaeeaeaoa iaaee/ieo iaoe ca niaoe?aeuei?noth 14.01.21 – o?aaiaoieia?y
? i?oiiaae?y. Iaoeiai-aeine?aeiee ?inoeooo o?aaiaoieia?? oa i?oiiaae??
IIC Oe?a?ie, Ee?a, 1999.

A iniiao ?iaioe iieeaaeaii aiae?c ?acoeueoao?a ianoaaeaiiy oa e?eoaaiiy
81 oai?iai ?c ?icaeiaeueieie eiio?aeoo?aie i’ynoeiai-oaeaiaiaeo noaeia?a
??ciiai aaiaco. Aia?oa ?ic?iaeaia nenoaia i?io?eaeoeee, e?eoaaiiy oa
i?neyiia?aoe?eii? ?aaa?e?oaoe?? oai?eo c ?icaeiaeueieie eiio?aeoo?aie
i’ynoeiai-oaeaiaiaeo noaeia?a, noai?aia eeaneo?eaoe?y ?icaeiaeueieo
eiio?aeoo? i’ynoeiai-oaeaiaiaeo noaeia?a, yea aea? iiaeeea?noue
aeeoa?aioe?eiaaiiai i?aeoiaeo aei e?eoaaiiy eiio?aeoo?, aecia/aiiy
oaeoeee oa ianyao iaaee/ii? aeiiiiiae ia ??cieo aoaiao e?eoaaiiy.
Aaeineiiaeaia iia?aoe?y iia?e?caoe?? i’ynoeiai-oaeaiaiaeo noaeia?a,
?ic?iaeaii oa ai?iaaaeaeaii a i?aeoeeo i?eno??e aeey ?? aeeiiaiiy,
?ic?iaeaia iaoiaeeea i?neyiia?aoe?eii? ?aaa?e?oaoe??. Aeieacaii, ui
?iaeea?aeoaeuei? iniaeeaino? iai?io eieaaaio aieeaathoue ia
ooieoe?iiaeuei? ?acoeueoaoe e?eoaaiiy iane?aee?a o?aai aa?oiuei?
e?ioe?aee. ?acoeueoaoe e?eoaaiiy ia?iaeee ca aaeineiiaeaiith iaoiaeeeith
Aia?eeainueei? anioe?aoe?? o??o?a?a eeno?. Aeei?enoaaoe ?ic?iaeai?
aaoi?ii iaoiaeeee, aeinyaee iie?auaiiy ooieoe?? eeno? oai?eo a
na?aaeiueiio ia 30%.

Eeth/ia? neiaa: eenoue, noaeiae, eiio?aeoo?e, i’ynoeiai-oaeaiaia?
noaeiae, ?icaeiaeuei? eiio?aeoo?e, ?aeiino?oeoeaii-a?aeiiai? iia?aoe??,
iia?e?caoe?y, ieanoeea, a?aeiiaeaiiy.

Annotation

Hayowitsch V.V. Surgical treatment of the extension contractures of
metacarpophalangeal joints in patients with upper extremity trauma
consequences. – Manuscript. Thesis for candidate’s for medical sciences
degree by speciality 14.01.21 – “Traumatology and orthopaedics”. — The
Ukrainian Research Institute for Traumatology and Orthopaedics, Kiev,
1999.

The results of surgical treatment of 81 patients with extension
contractures of metacarpophalangeal joints of different origin, have
been analyzed in this study. The system of preventive maintenance,
treatment and postoperative rehabilitation have been created. It was
proved that the functional results of the treatment related to
individual aspects of the collagen metabolism. For the first time the
classification of extension contractures of metacarpophalangeal joints
which enables to determine tactics approches to extension contractures
treatment depend on stages have been developed.The new device for
surgical metacarpophalangeal joint mobilization have been created and
present method of this operation have been improved. The new system of
postoperative rehabilitation of patients have been offered. Data were
assessed by improved system the American association of hand surgery.
Dye to authors original methods of treatment the hand function have been
improved on 30 % in average.

Key words: hand, joints, contractures, metacarpophalangeal joints,
extension contractures.

AIIIOAOeEss

Aaeiae/ A.A. Oe?o?ae/aneia ea/aiea ?icaeaaoaeueiuo eiio?aeoo?
iynoii-oaeaiaiauo nonoaaia o aieueiuo n iineaaenoaeyie o?aai aa?oiae
eiia/iinoe. – ?oeiienue. Aeenna?oaoeey ia nieneaiea iao/iie noaiaie
eaiaeeaeaoa iaaeeoeeineeo iaoe ii niaoeeaeueiinoe 14.01.21 –
o?aaiaoieiaey e i?oiiaaeey. Iao/ii-enneaaeiaaoaeueneee einoeooo
o?aaiaoieiaee e i?oiiaaeee IC Oe?aeiu, Eeaa, 1999.

Eeeie/aneay /anoue ?aaiou iniiaaia ia ?acoeueoaoao ea/aiey 81 aieueiiai
n ?EION ca iineaaeiea 15 eao. ?ani?aaeaeaiea aieueiuo ia eeeie/aneea
a?oiiu aue iaoneiaeai oyaeanoueth o?aai, ?acee/iuie oaeoe/aneeie
iiaeoiaeaie e ea/aieth, i?iaiicaie e iaoiaeaie ea/aiey. A ia?aoth
a?oiio aioae 21 iaoeeaio, a eioi?uo ?acaeaaoaeueiua eiio?aeoo?u
noi?ie?iaaeenue aneaaenoaee o?aai einoae eenoe e i?aaeiea/uey. A aoi?ie
a?oiia – 30 aieueiuo, e ?acaeaaoaeueiui eiio?aeoo?ai i?eaae ia?ae/iue
iuoa/iue aeenaaeain ia i?aaeiea/uea e eenoe ec-ca o?aai ia?aia,
nooiaeeeee e eoaie/aneiai iia?aaeaeaiey oeaiae. O o?aoueae a?oiiu – 11
aieueiuo, eiaei ianoi iia?aaeaeaiea ooieoeeiiaeueiuo no?oeoo? ouea eenoe
e i?aaeiea/uey, /oi auei ioneiaui iaoaieciii oi?ie?iaaiey eiio?aeoo?.
*aoaa?oay a?oiia iaoeeaioia c eiio?aeoo?aie niaoaiiiai aaiaca
ian/eouaaea 19 aieueiuo.

A aieueiuo ia?aie a?oiiu a ia?aoth i/a?aaeue ainnoaiaaeeaaee
aiaoiie/aneoth oeaeinoue e acaeiiioiioaiey iia?aaeaeaiiuo einoae
i?aaeiea/uey e eeno?. Aoi?ui yoaiii ainnoaiaaeeaaee ianneaiua aeaeaeaiey
a iynoii-oaeaiaiauo nonoaaao.

Iuoa/iue aeenaaeain aieueiuo aoi?ie eeeie/aneie a?oiiu o?aaiaae
ia?aii/a?aaeiiai ainnoaiiaeaiey oeaeinoe ia?aia, a neo/ayo, aaea eiaei
ianoi eo iia?aaeaeaiea e iicaieyee n?iee o?aaiu. Iiaeeecaoeeth nonoaaia
auiieiyee aoi?ui yoaiii. Oeaeinoue nooiaeeeee naeaaoaeae ainnoaiaaeeaaee
iooai aeaooyoaiiie ieanoeee i?e iia?aaeaeaieyo a e?eoe/aneie ciia,
noeaaieai eee iinoiaeaeiie ieanoeeie i?e iia?aaeaeaiee a 3–4 ciia. Ia?au
ainnoaiaaeeaaee ieanoeeie iae?io?ainieaioaoii ee?iiiaeiiai ia?aa. I?e
ionoonoaee aeoeaiiai naeaaiey a ION auiieiyee o?ainiiceoeeth iuooe.

Ionoonoaea eiaeiiai iie?iaa ii oueueiie iiaa?oiinoe eenoe e
i?aaeiea/uey o aieueiuo o?aoueae eeeie/aneie a?oiiu o?aaoao iniaie
iia?aoeaiie oaoieee e oaeoeee /a?ac aiaoiii-ooieoeeiiaeueioth
iniaaiiinoue ciiu. Eiaeiua eineoou ia ninoaeenouo iiaeeao, n aaoiiiiiui
ieoaieai a aeaiiuo neo/ayo anoue iaoiaeii auai?a aeey ono?aiaiey
eiio?aeoo? yoiai aaiaca. A ea/anoaa aea?iio?ainieaioaoia eniieueciaaee
?ioaoeeiiiue eo/aaie eineoo, eo/aaie eineoo ia i?ieneiaeueiie
ninoaeenoie iiaeea ni caei?iaiai i?aaeiea/uey, oi?aeiaei?caeueiee
eineoo, oueueiue eineoo noiiu, iaoiaue eineoo. Oniaoiinoue
iiaeeece?othueo iia?aoeee ai aoi?ii yoaia iaoneiaeea aiciiaeiinoue
ainnoaiiaeaiey caoaaoia iinea ieanoeee eee oaiieeca nooiaeeeee
?acaeaaoaeae o?aoueei yoaiii.

Naiie o?oaeiie eaoaai?eae aieueiuo auea /aoaa?oay eeeie/aneay a?oiia,
aaea aieueiua eiaee iauaaeeiaiiua o?aaiu ?acee/iuo ooieoeeiiaeueiuo
no?oeoo? e o?aaiaaee eiaeeaeaeoaeueiiai iiaeoiaea e ea/aieth n o/aoii
oaeoe/aneeo i?eioeeiia e iauaaeeiaieai a iaeiii yoaia ainnoaiiaeaiey
iaeneiaeueiiai eiee/anoaa o?aaie?iaaiiuo no?oeoo?.

Ia 25 aieueiuo enneaaeiaaee iaiai eieeaaaia e eioaineaiinoue i?ioeannia
oea?ice?iaaiey a ciia o?aaiu. Aeieacaee, /oi ia?ooaiey iaiaia eieeaaaia
anoue iaeiei ec iniiaiuo i?aaeiinueie oi?ie?iaaiey eiio?aeoo? iinea
o?aai eenoe e eiia/iinoe a oeaeii, i?e yoii ia/aeueiue iaoaaiee/aneee
oii o aieueiuo n ?acaeaaoaeueiuie eiio?aeoo?aie iynoii-oaeaiaiauo
nonoaaia (ION) eiaao cia/aiea i?e ieaie?iaaiee iia?aoeaiiai ea/aiey e
anoue aaaeiui i?iaiinoe/aneei i?eciaeii i?e auai?a oe?o?ae/aneie
oaeoeee.

Aeey eco/aiey iaoaieciia oi?ie?iaaiey ?acaeaaoaeueiuo eiio?aeoo?
iynoii-oaeaiaiauo nonoaaia, i?iaaee na?eth aiaoiie/aneeo,
iaoiii?oieiae/aneeo enneaaeiaaiee iai?aaeaiiuo ia eco/aiea aiaoiiee,
oeceieiaee, aeiiaoaieee, eae iynoii-oaeaiaiauo nonoaaia, oae e
ooieoeeiiaeueiuo ieieinonoaaiuo no?oeoo?. Aeey iiaeoaa?aeaeaiey
aeinoiaa?iinoe yenia?eiaioaeueiuo aeaiiuo ?ac?aaioaee iaoaiaoe/aneoth
iiaeaeue, eioi?ay iicaieeea iooai iaoaiaoe/aneeo ?an/aoia niiinoaaeoue e
eiio?iee?iaaoue aiaoiie/aneea e aeiiaoaie/aneea ?acoeueoaou, iieo/aiiua
a yenia?eiaioa. A ?acoeueoaoa iiuoa iieo/eee neaaeothuea aeaiiua: i?e
iieiii naeaaiee anao nonoaaia o?aooaeaiaiaiai iaeueoea, iauay yeneo?ney
?acaeaaoaey ninoaaeo i?eaeeceoaeueii 1,4 – 1,5 ni. Oneeea aeeeiiiai
?acaeaaoaey iaeaieaa yooaeoeaii a ?acaeaaiee ION. Ia IION aai aeaenoaea
ia?aaeaaony oieueei /anoe/ii e ii/oe ia ia?aaeaaony ia AeION. A
?acaeaaiee iaaeoaeaiaiauo nonoaaia aaaeioth ?ieue ea?atho nianoaaiiua
iuooeu eenoe, oneeea eioi?uo /anoe/ii ia?aaeathony /a?ac eaoa?aeueiua
io/ee nooiaeeeueii-aiiiaa?ioe/aneiai ?anoyaeaiey ?acaeaaoaey.
Aeiee?iaaiea nooiaeeeey aeeeiiiai ?acaeaaoaey i?iyaeyaony a ia?aoth
i/a?aaeue a ?acaeoee ?acaeaaoaeueiie eiio?aeoo?u ION, a iaiueoae ia?a
oooaeoaaony naeaaiea IION e i?aeoe/anee ia ia?aie/eaaaony ecaeaaiea
AeION.

?acoeueoaou ea/aiey ia?aaioaee ii oniaa?oainoaiaaiiie iaie iaoiaeeeie
Aia?eeaineie annioeeaoeee oe?o?aia eenoe ia ia?niiaeueiii eiiiuethoa?a.
Onoaiiaeee, /oi n?aaeiea iieacaoaee ooieoeee eenoe iaoiaeeeenue a i?yiie
caaeneiinoe io oyaeanoe o?aaiu e au?aaeaiiinoe eiio?aeoo?. A ia?aie
eeeie/aneie a?oiia ooieoeey eenoe n 56,05% oeo/oeeanue aei 81,31%,
aoi?ie a?oiiu n 34,96% aei 65,72%, o?aoueae a?oiiu n 44,95% aei 81,97%,
/aoaa?oie a?oiiu n 44,95% aei 68,09%.

Eeth/aaua neiaa: eenoue, nonoaau, eiio?aeoo?u, i’ynoii-oaeaiaiaua
nonoaau, ?acaeaaoaeueiua eiio?aeoo?u.

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