手指侧方组织块完全离断再植的临床体会

发布时间：2018-08-04 13:28

【摘要】：目的:探讨对手指侧方组织块完全离断行再植手术的必要性及方法。方法 :2012年3月至2015年4月,对62例各种原因导致手指组织块完全离断患者的治疗进行回顾性分析,其中男34例,女28例;年龄17~52岁,平均29.1岁。其中拇指27例,示指15例,中指13例,环指8例,小指2例,其中2指合并受伤3例,14例累及远侧指间关节;受伤至治疗时间30 min~2 h,平均1 h。全部采用急诊行再植术。术后随访观察手指外观、指端感觉及患指功能恢复情况。结果:62例完成手术者中58例成活,成活指随访3~15个月,平均6.5个月,按照中华医学会手外科学会上肢部分断指再植功能评定试用标准评定疗效,优52例,良3例,可3例,优良率94.8%。结论:对于手指侧方组织块离断再植存活后外观和功能良好,只要患者全身情况允许,远离断的指体尚完整,有可供吻合的血管和神经,都应力争对其进行再植。
[Abstract]:Objective: to investigate the necessity and method of replantation of lateral tissue mass of finger. Methods: from March 2012 to April 2015, a retrospective analysis was performed on 62 patients with complete amputation of finger tissue mass caused by various causes, including 34 males and 28 females, with an average age of 29.1 years (170-52 years). There were 27 cases of thumb, 15 cases of finger, 13 cases of middle finger, 8 cases of ring finger and 2 cases of small finger. Among them, 2 fingers were complicated with injury in 3 cases and 14 cases involved distal interphalangeal joint, the time from injury to treatment was 30 min~2 h (mean 1 h). All patients were treated with emergency replantation. The appearance of finger, the sensation of finger and the recovery of function of affected finger were observed after operation. Results of 62 patients, 58 survived, survival fingers were followed up for 3 ~ 15 months (mean 6.5 months). According to the evaluation criteria of replantation function of upper limb, 52 cases were excellent, 3 cases were good, 3 cases were fair, according to the evaluation standard of replantation function of the upper limb of the Chinese Medical Association, 52 cases were excellent, 3 cases were good, and 3 cases were fair. The excellent and good rate is 94. 8%. Conclusion: as long as the patient's whole body condition is allowed and the finger body far away from the amputated finger is intact and there are vessels and nerves to be anastomosed, it should be replanted as long as the patient has a good appearance and function after the replantation of the lateral tissue mass of the finger.
【作者单位】：浙江省台州骨伤医院;
【分类号】：R658.1

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