Kaplan F T, Raskin K B
NYU-Hospital for Joint Diseases, Department of Orthopaedic Surgery, New York, New York, USA.
Bull Hosp Jt Dis. 2001;60(3-4):179-88.
Finger amputations are devastating, life-changing injuries. They can occur from many different types of injury, but most often are caused by power tools or machinery in the workplace. Modern microvascular surgical techniques have enabled surgeons to successfully reattach fingers that have been amputated at almost level of injury. Patient outcome and digit viability have improved as surgeons have gained more experience with microvascular techniques, and have narrowed the operative indications for replantation. Currently, replantation is recommended for amputated thumbs, multiple digit amputations, and single digit amputations distal to the FDS insertion, as well as all amputations in children. Replantation surgery is technically demanding. Success relies on patient selection, meticulous operative technique, and postoperative monitoring. Most patients have successful outcomes with at least protective sensation and useful range of motion in the replanted digit. Though complications, including joint stiffness, tendon adhesions, malunion, and cold intolerance are not infrequent, patient satisfaction following replantation is high.
手指离断是极具破坏性且改变人生的损伤。它们可由多种不同类型的损伤导致，但最常见的是由工作场所的电动工具或机器造成。现代微血管外科技术使外科医生能够成功再植几乎在损伤平面处离断的手指。随着外科医生在微血管技术方面积累了更多经验，并缩小了再植的手术指征，患者的预后和断指的存活能力得到了改善。目前，对于拇指离断、多指离断以及在指浅屈肌止点远侧的单指离断，以及儿童的所有离断，均建议进行再植。再植手术对技术要求很高。成功依赖于患者的选择、细致的手术操作技术以及术后监测。大多数患者的预后良好，再植手指至少有保护性感觉和有用的活动范围。尽管包括关节僵硬、肌腱粘连、骨不连和不耐寒等并发症并不少见，但再植后患者的满意度很高。
