Department of Plastic and Reconstructive Surgery, Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Republic of Korea.
J Plast Reconstr Aesthet Surg. 2013 Feb;66(2):e43-6. doi: 10.1016/j.bjps.2012.10.017. Epub 2012 Nov 22.
A composite graft for reattachment of an amputated fingertip is a very controversial and challenging procedure. An osteocutaneous composite graft is rarely conducted and has a low success rate following fingertip amputation. A 21-year-old male patient was referred to our emergency clinic with dorsal oblique amputation of the middle, ring and small fingers of the left hand through the distal interphalangeal joint and middle phalanx. The amputated parts of the middle and ring fingers were reattached with osteocutaneous composite grafts. The amputated part of the small finger was revascularised to the ulnar palmar digital artery of the small finger. The composite grafts of the middle and ring fingers and the revascularised small finger survived completely. We suggest that careful patient selection will allow an osteocutaneous composite graft to become an acceptable method for the treatment of fingertip amputation. A large-scale study of osteocutaneous graft of amputated fingertips is required to improve the survival rate.
复合移植物再附着断指是一项极具争议性和挑战性的手术。骨皮复合移植物很少进行,且在指尖离断后成功率较低。一名 21 岁男性患者因左手中指、环指和小指通过远指间关节和中节指骨背侧斜行离断,被送至我院急诊。采用骨皮复合移植物将中指和环指的断指部分再附着,小指的断指部分通过尺侧掌侧指动脉再血管化。中指和环指的复合移植物和再血管化的小指完全存活。我们建议,仔细选择患者将使骨皮复合移植物成为治疗指尖离断的一种可接受的方法。需要进行大规模的研究以提高骨皮移植物治疗断指的成活率。