Hoang N T
Department of Traumatology, Orthopedics and Hand Surgery of Central Hospital 108, Hanoi, Vietnam.
J Hand Surg Br. 2006 Feb;31(1):9-17. doi: 10.1016/j.jhsb.2005.09.018. Epub 2005 Dec 15.
Five completely amputated hands at the level of the wrist joint were replanted. The five patients were all men, ranging from 19 to 31 years and the amputations were all the result of knife injuries. All the revascularizations were successful. Secondary tenolysis was required in one case. Postoperative functional results compared to the uninjured hand were evaluated according to five main criteria: (1) the patient's overall satisfaction with the hand; (2) recovery of flexor and extensor function of the thumb and fingers; (3) recovery of thumb opposition; (4) recovery of sensitivity in the median and ulnar nerve distributions; (5) ability of the surviving hand to perform daily tasks. The results showed that, although the replanted hands were never functionally as good as the contralateral hand, the patients were able to use them satisfactorily for activities of daily living. Our results demonstrate that replantation following complete amputation at the wrist joint level as a result of a sharp injury is extremely worthwhile and has excellent potential for functional recovery.
对5例腕关节平面完全离断的手部进行了再植。5例患者均为男性，年龄在19岁至31岁之间，断肢均由刀伤所致。所有血管再通均成功。其中1例需要进行二期肌腱松解术。根据以下五个主要标准评估术后与健侧手相比的功能结果：(1)患者对患手的总体满意度；(2)拇指和手指屈伸功能的恢复；(3)拇指对掌功能的恢复；(4)正中神经和尺神经分布区域感觉的恢复；(5)存活手执行日常任务的能力。结果表明，尽管再植手的功能从未达到对侧手的水平，但患者能够满意地使用它们进行日常生活活动。我们的结果表明，因锐器伤导致腕关节平面完全离断后进行再植是非常值得的，并且具有极佳的功能恢复潜力。
