Bowen C V, Beveridge J, Milliken R G, Johnston G H
Department of Orthopaedic Surgery, University Hospital, Saskatoon, Saskatchewan, Canada.
J Hand Surg Am. 1991 Jan;16(1):117-21. doi: 10.1016/s0363-5023(10)80024-3.
In a three-year period twenty-nine patients were treated for rotating shaft avulsion amputations of the thumb. Twenty-three thumbs were considered suitable for replantation. A staged approach, consisting of primary replantation and secondary nerve grafting and tendon reconstruction, was used because of concern that survival rates would be low. Survival was achieved in nineteen of twenty-three replantations. At mean follow-up of 20.5 months grip strength was 94.6% of the unaffected side and key pinch was 77.1%. Five patients achieved a two-point discrimination less than five millimeters. Success was better anticipated and now a full reconstruction is carried out in a single-stage procedure.
在三年时间里，有29例患者接受了拇指旋转撕脱性截肢的治疗。其中23例拇指被认为适合再植。由于担心存活率会很低，采用了一种分阶段的方法，包括一期再植、二期神经移植和肌腱重建。23例再植手术中有19例成功存活。平均随访20.5个月时，握力为健侧的94.6%，捏力为健侧的77.1%。5例患者的两点辨别觉小于5毫米。现在可以更好地预测手术成功率，并且现在可以通过单阶段手术进行完全重建。
