摘要
目的 分析断指再植应用可吸收髓内钉固定指骨的疗效。 方法 2 0 0 1年 9月～ 2 0 0 3年 10月 ,对 2 8例工业性断指 ,男 2 1例 2 1指 ,女 7例 7指 ;年龄 18～ 35岁。指别 :食指 11例 ,中指 8例 ,环指 6例 ,小指 3例 ,其中近节指骨 15例 ,中节指骨 11例 ,末节指骨 2例。于伤后 1～ 6 h进行急诊再植 ,并应用自行研制的可吸收消旋聚乳酸 (poly- DL-lactic acid,PDL L A)混合壳聚糖髓内钉固定指骨。手术先扩大指骨髓腔 ,然后安插合适直径和长度的髓内钉进行固定 ,术后用树脂绷带固定 3～ 4周。 结果 2 8例断指再植均成活 ,术后随访 3～ 10个月 ,平均 4个月。有 1例于术后 3周出现排异反应 ,余 2 7例在随访期内骨折均达骨性愈合。按中华医学会手外科学会断指再植功能评定试用标准 :优 18指 ,良9指 ,差 1指 ,总优良率 96 .4 %。 结论 可吸收 PDL L A混合壳聚糖髓内钉是断指再植固定指骨的一种理想方法。
Objective To study the effect of internal fixation with absorbable intramedullary nail on the treatment of phalange fractures in replantation of severed finger. Methods From September 2001 to October 2003, 28 cases with industrial severed finger (21 males and 7 females, with the age of 18 35 years) were replanted within 1 6 hours. The severed locations were index fingers in 11 cases, middle fingers in 8 cases, ring fingers in 6 cases, little fingers in 3 cases. All cases of phalange fractures were fixed by absorbable intramedullary nails of poly DL lactic acid(PDLLA) that combined with chitosan. Out of the 28 cases, 15 cases were with proximal phalange, 11 cases were with middle phalange, 2 cases were with distal phalange. The bone marrow cavity of the phalanges were dilated, then the intramedullary nail was inserted with suitable diameter and length to fix the fracture. Postoperatively resin bandage was applied for 3 4 weeks.Results All the 28 patients survived the performance and postoperative follow up ranged from 3 to 10 months (4 months in average). Rejection was observed in one case 3 weeks after operation, bone unions were obtained in other cases. According to the Chinese Medical Association's evaluation standard for replantation of amputated finger, 18 fingers resulted in excellence, 9 fingers in good function and 1 with unsatisfactory function. The excellent and good rate was 96.4%. Conclusion Internal fixation with absorbable intramedullary nail of PDLLA combined with chitosan proves to be effective in the replantation of severed finger.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2005年第3期204-206,共3页
Chinese Journal of Reparative and Reconstructive Surgery
基金
广东省卫生厅科研基金资助项目 (A2 0 0 2 835)~~
