Goksu Sitki, Kocoglu Hasan, Yildirim Cuma, Tutak Atilla, Oner Unsal
Gaziantep Universitesi Tip Fakultesi Anesteziyoloji ve Reanimasyon Anabilim Dali, Gaziantep, Turkey.
Ulus Travma Derg. 2002 Oct;8(4):259-63.
It is difficult to decide replantation or revascularization in partial or total amputations proximal to the wrist. Important point is the expected functional result and/ or protection of sensibility. Crush type partial or total amputations have poor prognosis. In addition to the vascular injury there are also broad cutaneous and muscular injury which have a potential risk for necrosis and infection. And this may threat the patient's life. In this case report, as two major nerves seemed intact, arterial reconstruction by a vein graft 22 cm. long and protection of important structures such as vein graft, nerves and bone which were exposed after debridement was performed by pedicled latissimus dorsi muscle flap in an above-elbow partial amputation caused by crush injury, and successful result was obtained. Key Words: Major limb amputation, revascularization, vein graft, pedicled muscle flap.
对于腕关节近端的部分或完全离断伤，很难决定是进行再植还是血管重建。关键在于预期的功能结果和/或感觉功能的保护。挤压型部分或完全离断伤预后较差。除血管损伤外，还存在广泛的皮肤和肌肉损伤，有坏死和感染的潜在风险。这可能会威胁患者生命。在本病例报告中，由于两条主要神经似乎完好，在一例因挤压伤导致的肘上部分离断伤中，采用了一段22厘米长的静脉移植物进行动脉重建，并通过带蒂背阔肌肌瓣对清创后暴露的静脉移植物、神经和骨骼等重要结构进行保护，获得了成功的结果。关键词：肢体大段离断伤、血管重建、静脉移植物、带蒂肌瓣
