Paulos Renata Gregorio, Simão Danielle Tiemi, Mattar Júnior Rames, Wei Marcelo Rosa de Rezende Teng Hsiang, Torres Luciano Ruiz
Hand Group of the Institute of Orthopedics and Traumatology of Hospital das Clínicas of the School of Medicine of Universidade de São Paulo - São Paulo, SP, Brazil.
Acta Ortop Bras. 2012;20(2):104-9. doi: 10.1590/S1413-78522012000200009.
Retrospective evaluation of cases of limb replantation after avulsion injuries. Evaluation of the techniques and tactics used, that contributed to success and good functional results.
Forty-three patients' records were assessed. All the cases had been submitted to limb replantation after avulsion injuries.
The majority of the cases were young men. The most common injury was to the thumbs. The surgical techniques and tactics used were: nerve grafting, vein grafting, transposition of the digital vessels, limb shortening, and heterotopic replantation. The most commonly used technique was vein graft. The limb survival rate was high (93%), as was patient satisfaction.
Replantation after avulsion injury depends on the correct diagnosis of the limb viability and the use of appropriate surgical techniques and tactics for each case. The experience of the team of surgeons and a good hospital structure are essential for good results. There are few articles in medical literature about the indications, techniques and results of limb replantation after avulsion injuries. We believe that this retrospective evaluation can bring new information and contributions to the correct management of this highly complex situation. Level of evidence IV, Case Series.
对撕脱伤后肢体再植病例进行回顾性评估。评估有助于成功及获得良好功能结果的技术和策略。
评估了43例患者的记录。所有病例均为撕脱伤后接受肢体再植。
大多数病例为青年男性。最常见的损伤部位是拇指。所采用的手术技术和策略包括：神经移植、静脉移植、指血管转位、肢体缩短和异位再植。最常用的技术是静脉移植。肢体存活率高（93%），患者满意度也高。
撕脱伤后的再植取决于对肢体存活能力的正确诊断以及针对每个病例采用适当的手术技术和策略。外科医生团队的经验和良好的医院架构对于取得良好结果至关重要。医学文献中关于撕脱伤后肢体再植的适应证、技术和结果的文章很少。我们认为，这种回顾性评估可为正确处理这种高度复杂的情况带来新的信息和贡献。证据等级IV，病例系列。
