摘要
目的 探讨拇指末节旋转撕脱性离断的特点及再植的可行性.方法 对38例拇指末节旋转撕脱性离断患者,采用不同方法 进行再植,并至少吻合一侧指固有动脉,直接或行静脉移植重建静脉回流,不能吻合静脉者,行甲床或指尖侧切放血,指固有神经均急诊予修复.结果 38例断指再植术后成活34例,4例坏死,成活率89.5%,全部成活病例进行随访,时间为6个月～3年,患指大多恢复了良好外观、功能、感觉.除恢复痛、温、触觉外,两点分辨觉为5～12 mm,平均为8 mm.根据评定试用标准,优26例,良5例,差3例.结论 拇指末节旋转撕脱性离断是一种特殊类型断指,但只要断指的指体完整,清创后可找到供吻合的血管,采用正确再植方法 ,仍有很高的成活率,应尽量予以再植.
Objective To explore the characteristics of rotate avulsion amputation on distal thumb, and the feasibility of replantation. Methods Of 38 patients with rotate avulsion amputation on distal thumb, using different methods, and at least coincide one side finger＇s inherent artery anastomosis, or directly refer to do vein transplantation to reconstruct venous backflow, and if patients who can＇t inosculate vein, then we can conduct the hyponyehium or sideeut bloodletting on fingers, because it has nerve in fingers, so that it should be repaired in emergency. Results Of 38 patients after the surgery of replantation, 34 patients＇ survived, 4 eases of necrosis, the survival rate is 89.5%. all survived cases were followed ranging from 6 months to 3 years, the injured fingers were abnost recovered their appearances, functions, and feelings. Except the recovery of sense of pain,warmth and touch, the distance between two pionts can reachfor 5 to 12 mm, an average of about 8 mm. According to the evaluation standard, 26 cases are optimal recovered, 5 cases are good, 3 cases are bad. Conclusion Rotate avulsion amputation on distal thumb is a special type of digit broken, but as long as the digit body is complete, it can be found for anastomosis after debridement of blood vessels, and using the correct replantation method, there are still high survival rate, it should try to do the replantation.
出处
《中国医学创新》
CAS
2011年第11期15-16,共2页
Medical Innovation of China
关键词
拇指末节
旋转撕脱性
离断伤
再植术
Distal thumb
Reverse avutsion
Injuries from broken
Replantation
