Yang Z H, Zhou B G, Peng Z R
Department of Hand Surgery, Fourth People's Hospital of Wuhan, Wuhan Hubei, P. R. China 430033.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2001 Nov;15(6):370-2.
To discuss the indication of replantation of destructive amputation of multiple fingers for improvement of the function of injured fingers.
From February 1996 to August 1999, 23 amputated fingers in 8 cases were shortened and replanted. The crushed digital bones were fixed by Kirschner wires, flexor tendons repaired by Kessler suture technique, and digital extensor tendons repaired by mattress suture. The arteries and veins were anastomosed in each finger at the ratio of 1 to 2 or 2 to 3. The defect of blood vessels was repaired by free graft of autologous veins in 5 fingers. All of the cases were followed up for 10 to 18 months, and clinical evaluation was performed.
All replanted fingers survived in the 8 cases, with good sensation, two point discrimination of 6 to 12 mm, and satisfied function, such as pinching, grasping and hooking. The fingers were shortened for 2.6 cm in average, ranging from 2.2 cm to 4.0 cm.
Multiple digits replantation by shortening fingers is beneficial to functional restoration of segmental destructive fingers.
探讨多指毁损性离断再植的适应证,以改善伤指功能。
1996年2月至1999年8月,对8例23指离断伤行缩短再植。粉碎性指骨用克氏针固定,屈指肌腱用Kessler缝合法修复,指伸肌腱用褥式缝合法修复。各手指动静脉按1∶2或2∶3比例吻合,5指血管缺损采用自体静脉游离移植修复。所有病例随访10~18个月并进行临床评价。
8例再植指全部成活,感觉良好,两点辨别觉为6~12mm,捏、抓、钩等功能满意。手指平均缩短2.6cm,范围为2.2~4.0cm。
手指缩短再植多个手指有利于节段性毁损手指的功能恢复。