Freeland Alan E, Psonak Rick
Dept of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson, MS 39216-4505, USA.
Orthopedics. 2007 Feb;30(2):120-6. doi: 10.3928/01477447-20070201-16.
Prehension, intelligence, and erect posture distinguish humans from lower animals. Hands are instrumental for our survival and welfare. We use our hands when we work, recreate, and communicate. A handshake, a touch, a sign, or signal has significant social and communicative meanings. Hands play a major role in defining the skill level of our activities and our level of social expression and integration. Indeed, refined psychomotor precision of hand function may distinguish some individuals among us, gifting society with its more skilled craftsmen, surgeons, artisans, musicians, athletes, and the like in a highly digital world. For others, their hands are critical in providing and caring for their families. Injury severity scores may identify the majority of patients that require amputation; however, injury severity scoring system predictions in individual patients may be problematic and should be used with caution. Amputees require comprehensive multidisciplinary treatment and compassion so that they can successfully overcome their losses. Ultimately, the patients must change, adjust, and adapt to successfully reintegrate themselves into their families, peer groups, job settings, and society as a whole. Early amputation may decrease the incidence and severity of phantom pain compared to amputation after the failure of reconstruction. Early prosthetic fitting, training, and physical rehabilitation; early psychological and sociological support; and early return to work facilitate successful functional recovery. Psychological recovery may be a more arduous and extended process than physical recovery. We must teach our amputees from the outset to use their losses as an incentive for success, assist them to regain their quality of life, and encourage them to act as role models for and to educate others.
抓握能力、智力和直立姿势使人类有别于低等动物。手对我们的生存和福祉至关重要。我们在工作、娱乐和交流时都会用到手。握手、触摸、手势或信号都具有重要的社会和交流意义。手在界定我们活动的技能水平以及社会表达和融入程度方面发挥着主要作用。事实上，手部功能精细的心理运动精准度可能使我们中的一些人脱颖而出，在这个高度数字化的世界里为社会造就更技艺娴熟的工匠、外科医生、工匠、音乐家、运动员等等。对另一些人来说，他们的手对于供养和照顾家人至关重要。损伤严重程度评分可能会确定大多数需要截肢的患者；然而，个体患者的损伤严重程度评分系统预测可能存在问题，应谨慎使用。截肢者需要全面的多学科治疗和关怀，以便他们能够成功克服所遭受的损失。最终，患者必须做出改变、调整和适应，才能成功地重新融入家庭、同龄人群体、工作环境以及整个社会。与重建失败后截肢相比，早期截肢可能会降低幻肢痛的发生率和严重程度。早期安装假肢、进行训练和身体康复；早期给予心理和社会学支持；以及早期重返工作岗位有助于实现成功的功能恢复。心理恢复可能是一个比身体恢复更艰巨、更漫长的过程。我们必须从一开始就教导截肢者将他们的损失转化为成功的动力，帮助他们重获生活质量，并鼓励他们成为他人的榜样并教育他人。
