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八年断指再植临床经验:人口统计学特征与结果

Eight years of clinical experience with digit replantation: Demographic characteristics and outcomes.

作者信息

Oruç Melike, Gürsoy Koray, Özer Kadri, Çolak Özlem, Kankaya Yüksel, Sungur Nezih, Ulusoy Gürhan Mustafa, Koçer Uğur

机构信息

Department of Plastic, Reconstructive and Aesthetic Surgery, Ankara Training and Research Hospital, Ankara-Turkey.

出版信息

Ulus Travma Acil Cerrahi Derg. 2017 Jul;23(4):311-316. doi: 10.5505/tjtes.2016.40040.

Abstract

BACKGROUND

Despite surgical and technical advances in microsurgery, it is still difficult to obtain satisfactory results after replantation of finger amputation. The aim of the present study was to discuss some of the many factors that can affect the success rate of replantation.

METHODS

A retrospective analysis of 60 patients with 85 finger replantations was performed. Revascularizations and replantations proximal to the metacarpophalangeal joint were excluded. Demographic characteristics of the patients, place of injury, mechanism of injury, level of amputation, and success rate were examined.

RESULTS

A total of 53 male and 7 female patients with mean age of 31 years were included in the study. Index finger (27%) was the most commonly replanted digit. Left side was the more affected, with 62%. Mechanism of injury was crush in 56%, guillotine in 23%, and avulsion in 21% of replanted digits. Success rate was 81%, 53%, and 36% in guillotine, crush, and avulsion injuries, respectively.

CONCLUSION

In conclusion, the injury type and personal variables are very important in the rate of replantation success. Knowledge about the effects of different factors on the results of replantation surgery will provide guidance to hand surgeons in order to inform patients and their relatives properly.

摘要

背景

尽管显微外科手术技术取得了进步,但手指离断再植术后仍难以获得满意的效果。本研究旨在探讨影响再植成功率的诸多因素。

方法

对60例患者的85例手指再植病例进行回顾性分析。排除掌指关节近端的血管再通和再植病例。检查患者的人口统计学特征、受伤部位、损伤机制、断指水平和成功率。

结果

本研究共纳入53例男性和7例女性患者,平均年龄31岁。示指(27%)是最常进行再植的手指。左侧受伤更为常见,占62%。再植手指的损伤机制中,挤压伤占56%,切割伤占23%,撕脱伤占21%。切割伤、挤压伤和撕脱伤的再植成功率分别为81%、53%和36%。

结论

总之,损伤类型和个体变量对再植成功率非常重要。了解不同因素对再植手术结果的影响,将为手外科医生提供指导,以便恰当地告知患者及其亲属。

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