Szczesny Grzegorz, Bazała Maciej
Katedra i Klinika Ortopedii i Traumatologii Narzadu Ruchu, Warszawski Uniwersytet Medyczny, Warszawa.
Chir Narzadow Ruchu Ortop Pol. 2011 Mar-Apr;76(2):110-4.
Summary We present two cases of successful microsurgical replantation and revascularization of the thumb of dominating extremity in young men performed in orthopedic department, to whom operative treatment in specialized replantation center could not be performed. Microvasculature of the finger was restored anastomosing microsurgically its artery and vein under operative microscope, and bone fracture was stabilized intramedullary with Kirschner wires. In both cases vitality of the finger was restored, which enabled proper healing of soft tissues and bone, leading to restoration of satisfactory function of the thumb. Due to high value for the function of the hand, thumb injuries threading with its loss should be managed primarily. Due to small vessel diameter those procedures require special instrumentation and trained personnel, and thus shouldbe done in replantation centers. Nevertheless, when treatment in an appropriate center is unavailable, those procedures could also be successfully performed by trained orthopedists.
摘要 我们报告了两例在骨科进行的成功的显微外科再植和血管重建手术，手术对象为两名年轻男性优势手拇指离断伤患者，他们无法在专业再植中心接受手术治疗。在手术显微镜下通过显微外科吻合手指的动静脉来恢复其微血管系统，并用克氏针进行髓内固定以稳定骨折。两例患者手指均恢复了活力，这使得软组织和骨骼得以正常愈合，从而恢复了拇指令人满意的功能。由于拇指对手的功能具有重要价值，对于可能导致拇指缺失的损伤应优先进行处理。由于血管直径小，这些手术需要特殊的器械和训练有素的人员，因此应在再植中心进行。然而，当无法在合适的中心进行治疗时, 经过培训的骨科医生也可以成功地完成这些手术。
