Kubus Maciej, Andrzejewska Ewa, Kuzański Wojciech
Department of Paediatric Surgery and Oncology, Maria Konopnicka University Hospital No. 4, Łódź, Poland. mtkubus@gma il.com
Ortop Traumatol Rehabil. 2011 Nov-Dec;13(6):547-54. doi: 10.5604/15093492.971039.
Fingertip injuries are the most common hand injuries in children seeking medical advice at trauma care centres. Most cases are treated conservatively and hospitalisation is not necessary. However, surgery under general anaesthesia is often required on account of severity of the injuries and the patients' young age. The aim of the paper is to discuss a series of patients treated in the Department of Paediatric Surgery and Oncology between 2008 and 2010, and present the problems associated with surgical care in fingertip injuries in children.
A total of 76 children were treated in the Department of Pediatric Surgery and Oncology between 2008 and 2010 because of fingertip injuries. This group is estimated to represent approx. 10% of all patients admitted to the Emergency Unit. Fingertip injuries were treated with situation sutures, V-Y-plasty, suturing back the amputated fingertip and by suturing into thenar skin. Data were extracted from medical files and presented as percentages.
There were 50 boys in the group of 76 children (65.79%). Mean age was 7 years. Most of the patients were children aged 1 to 5 years (36 patients, 47.37%). In 45 children (59%), the right hand was injured. Injury to fingers responsible for the pincer grasp occurred in 29 children (38.16%).
Fingertip injuries are among the most common injuries in children and preservation of the hand's motor abilities depends on thorough surgical care. Most children with fingertip injuries are treated in Emergency Units and only 10% of patients need surgery under general anaesthesia after hospital admission. A number of surgical techniques can be used in the management of fingertip injuries in children. These techniques represent adaptations of methods used in adults. A model for the evaluation of severity and management of fingertip injuries in children should be established.
指尖损伤是创伤护理中心寻求医疗建议的儿童中最常见的手部损伤。大多数病例采用保守治疗,无需住院。然而,由于损伤的严重程度和患者年龄较小,通常需要在全身麻醉下进行手术。本文旨在讨论2008年至2010年间在小儿外科和肿瘤学系治疗的一系列患者,并介绍儿童指尖损伤手术护理相关的问题。
2008年至2010年间,小儿外科和肿瘤学系共治疗了76例因指尖损伤的儿童。该组估计约占急诊室所有入院患者的10%。指尖损伤采用原位缝合、V-Y皮瓣成形术、将离断的指尖缝合回原处以及缝合至大鱼际皮肤等方法进行治疗。数据从医疗档案中提取并以百分比形式呈现。
76名儿童组中有50名男孩(65.79%)。平均年龄为7岁。大多数患者为1至5岁的儿童(36例,47.37%)。45名儿童(59%)右手受伤。负责捏取动作的手指受伤的儿童有29名(38.16%)。
指尖损伤是儿童中最常见的损伤之一,手部运动能力的保留取决于全面的手术护理。大多数指尖损伤的儿童在急诊室接受治疗,入院后只有10%的患者需要在全身麻醉下进行手术。多种手术技术可用于儿童指尖损伤的处理。这些技术是对成人所用方法的改编。应建立儿童指尖损伤严重程度评估和处理的模型。