Neinstein Ryan M, Dvali Linda T, Le Suzanne, Anastakis D J
Department of Plastic and Reconstructive Surgery, University of Toronto, Toronto, ON Canada.
Hand (N Y). 2012 Sep;7(3):263-6. doi: 10.1007/s11552-012-9427-z.
As a result of growing expertise and skill, replantation surgery has evolved to more than the technical reattachment of an amputated part.
A retrospective study of complete digital amputations undergoing replantation surgery was conducted for the purpose of assessing trends in these complex cases. All incomplete and partial amputations were excluded.
A total of 171 patients who had replantation surgery between January 1, 1994 and December 31, 2003 for 278 completely amputated digits were reviewed. Of the 171 patients, 91 (53 %) had work-related injuries. The main mechanism of injury was saw injury (95 patients) for both occupational- and non-occupational-related injuries. The proximal phalanx was the most common level of amputation and the thumb was most frequently involved. The injuries happened more commonly in the summer months. Microvascular failure occurred in 29 % of the replanted digits and was most commonly associated with avulsion-type injuries.
Complete amputations represent a more complex injury than incomplete amputations, with a higher failure rate.
由于专业知识和技能的不断提高，再植手术已不仅仅是对离断肢体进行技术性重新连接。
对接受再植手术的完全性手指离断进行回顾性研究，以评估这些复杂病例的趋势。所有不完全离断和部分离断均被排除。
对1994年1月1日至2003年12月31日期间因278例完全离断手指接受再植手术的171例患者进行了回顾。在这171例患者中，91例（53%）为工伤。工伤和非工伤的主要致伤机制均为锯伤（95例）。近节指骨是最常见的离断部位，拇指最常受累。损伤在夏季更为常见。29%的再植手指发生微血管功能障碍，最常与撕脱伤相关。
完全离断比不完全离断损伤更复杂，失败率更高。
