摘要
本文报告4例全手Ⅲ度烧伤的早期治疗,包括手指环状焦痂切开减压。手背区、鱼际一腕区及掌指叠切瓣曩皮。指背区深及骨面关节者,待上述三区檀戍愈合良好后,及早作指背区指骨皮质去除,新鲜骨髓创面植皮和指端修整,从而保留手指长度。皮片生长后,逐步弯曲手指铝夹板,使指间关节强直于功能位。4例随诊均取得良好的功能效果。
Treatment and result of burned total hand was reported here in 4 hands (4 cases). According to the treatment and anatomical characteristics, burned hand was divided into 4 areas: dorsum of hand, dorsum of finger, thenar-wrist area and volar-digit area. The treatment of total hand in third degree burns included emergency escharotomy of hand and digits, early escharectomy and immediate skin grafting on the dorsum of hnd,thenarwrist and volar-digit area. But on the dorsum of digit area this sort of hand was often deepen to the phalangeal bones and Joints. After healing of early graft, the exposed bones and joints were decorticated with immediate grafting on the fresh bone marrow surface and with the finger tip repair so as to preserve the length of digits. When the bone marrow surface grafting healed metallic finger splints were bent sequentially to functional position for 8 weeks in order to ankylosis of interphalangeal joints. Followed up 4 hands with good results. And only 5 distal phalanges were lose in 20 digits. But in previous cases this kinds of digits were often amputated with poor results
