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一例无静脉移植的完全撕脱伤成功再植手

Successful Hand Replantation in a Case of Total Avulsion without Vein Graft.

作者信息

Sulaiman Shatha M, Alkhodair Abdulmalik A, Sulaiman Shahd M, Sulaiman Lama M, Elkafafy Ahmed S

出版信息

Plast Reconstr Surg Glob Open. 2018 Jan 18;6(1):e1637. doi: 10.1097/GOX.0000000000001637. eCollection 2018 Jan.

Abstract

Replantation is the reattachment of a severed body part, with attempts to restore neurovascular and musculoskeletal integrity, function, and aesthetics. On September 7, 1964, the first extremity replantation-a completely amputated hand-by vascular anastomosis technique was successfully performed. Soon after, the first replantation of a complete thumb amputation using microvascular anastomosis in a human was successfully conducted by Komatsu et al. in 1968. The overall success rate of limb replantation surgery is around 83.2%. The mechanism of injury plays a role in the outcome; guillotine amputations-for example-carry a better prognosis than crush amputations. We present a case report of a 36-year-old male patient who presented with a total avulsion of the right hand with multiple fracture levels at the level of trans-carpal, distal radius extra-articulation fracture, and total avulsion of the hand. The patient was managed by a multidisciplinary team who were able to reattach his hand successfully with good functional outcome.

摘要

再植是指将离断的身体部分重新接上,旨在恢复神经血管以及肌肉骨骼的完整性、功能和美观性。1964年9月7日,首例通过血管吻合技术进行的肢体再植——完全离断的手部——手术成功完成。此后不久,小松等人于1968年成功完成了首例在人体中使用微血管吻合技术进行的完全性拇指离断再植手术。肢体再植手术的总体成功率约为83.2%。损伤机制对手术结果有影响;例如,切割伤断肢的预后比挤压伤断肢更好。我们报告一例36岁男性患者,其右手完全撕脱,伴有经腕关节水平的多处骨折、桡骨远端关节外骨折以及手部完全撕脱。该患者由一个多学科团队进行治疗,该团队成功地为他接上了手,功能恢复良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8960/5811296/e86036b28589/gox-6-e1637-g001.jpg

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