Beyermann K, Hahn P, Mutsch Y, Lanz U
Klinik für Handchirurgie, Abteilung I, Rhön-Klinikum, Bad Neustadt/Saale.
Handchir Mikrochir Plast Chir. 2000 Mar;32(2):88-92. doi: 10.1055/s-2000-19254.
Following replantation in childhood, growth disorders of the affected epiphysis can influence function and aesthetic appearance of the hand. In a retrospective study long-term results of replantation in the upper limb in childhood were analysed with respect to factors influencing further growth. 22 patients with 29 replanted fingers were reviewed clinically and radiologically after an average interval of ten years. An average bone growth of 93% compared to the contralateral non-injured side was found. With the epiphysis affected, bone growth was reduced to 86% of the contralateral side. Analysis of single phalanges showed a growth rate of 71 to 100% in phalanges distal to the amputation and also in phalanges initially severed. Potential factors influencing bone growth were assessed separately. Best results were achieved in straight injuries without epiphyseal affection. An influence of anoxia time or number of anastomosed vessels could not be found. Even though replantation in childhood affects growing bone, almost normal bone growth can be expected afterwards.
儿童期再植后,受影响骨骺的生长紊乱会影响手部功能和美观。在一项回顾性研究中,分析了儿童期上肢再植的长期结果以及影响进一步生长的因素。对22例患者的29根再植手指进行了临床和放射学检查,平均随访间隔为10年。发现与对侧未受伤侧相比,平均骨生长率为93%。当骨骺受影响时,骨生长减少到对侧的86%。对单个指骨的分析显示,截肢远端指骨以及最初离断的指骨的生长率为71%至100%。分别评估了影响骨生长的潜在因素。在没有骨骺受累的直线损伤中取得了最佳结果。未发现缺氧时间或吻合血管数量的影响。尽管儿童期再植会影响正在生长的骨骼,但之后仍可预期几乎正常的骨生长。