Dec Pawel, Bartosik Kalina, Chrachol Joanna, Puchalski Piotr, Zyluk Andrzej
Ann Acad Med Stetin. 2013;59(1):49-52.
This study records the outcomes of the treatment of 21 patients, 19 men and two women, who sustained an amputation of the total of 35 digits (27 fingers and eight thumbs). Eleven patients received replantation or reconstruction maintaining the length of the digit, whereas ten had their digits terminalized.
The results were assessed at a mean of 5 years after injury. Patients with finger stumps had stronger grip than those with replanted digits (72% vs 48% of strength of the healthy hand). Hand function as assessed by quickDASH score (29 vs 33), quality of life as assessed by SF-36 score (63 vs 67) and number of patients experiencing cold sensitivity (7 vs 7) were similar in both groups. Patients after terminalization returned to work significantly earlier than those after replantation or reconstruction (6 vs 12 months).
These results show that - considering function of the hand - replantation or advanced reconstruction offers the patient less benefit than simple terminalization.
本研究记录了21例患者的治疗结果,其中男性19例,女性2例,共35指(27指和8拇指)被截肢。11例患者接受了保留手指长度的再植或重建手术,而10例患者进行了手指截短术。
在受伤后平均5年对结果进行评估。手指残端患者的握力比再植手指的患者更强(分别为健侧手力量的72%和48%)。两组患者通过quickDASH评分评估的手部功能(分别为29和33)、通过SF-36评分评估的生活质量(分别为63和67)以及出现冷敏感的患者数量(均为7例)相似。接受截短术的患者比接受再植或重建手术的患者更早重返工作岗位(分别为6个月和12个月)。
这些结果表明,从手部功能考虑,再植或高级重建给患者带来的益处不如简单的截短术。