Charpentier K, Loisel F, Menu G, Feuvrier D, Obert L, Pluvy I
Service de chirurgie orthopédique et traumatologique, chirurgie plastique, esthétique et reconstructrice, chirurgie de la main, CHRU Minjoz, 3, boulevard Alexander-Fleming, 25030 Besançon cedex, France.
Service de chirurgie orthopédique et traumatologique, chirurgie plastique, esthétique et reconstructrice, chirurgie de la main, CHRU Minjoz, 3, boulevard Alexander-Fleming, 25030 Besançon cedex, France; Unité de recherche Nanomedicine Lab, Imagery & Therapeutics EA4662, université de Bourgogne-Franche-Comté, 16, route de Gray, 25030 Besançon, France.
Hand Surg Rehabil. 2019 Dec;38(6):375-380. doi: 10.1016/j.hansur.2019.09.001. Epub 2019 Sep 12.
We sought to evaluate the long-term quality of life and functional outcome of patients who underwent digital replantation after amputation. A retrospective single-center study was conducted of patients treated between January 2010 to May 2016. Twenty-eight patients who underwent successful replantation after single or multiple digital amputation were reviewed in person after at least 2years' follow-up (mean 4.6years). Total active range of motion, grip and pinch strength were assessed. Functional outcomes were evaluated using the SF-36 and DASH questionnaires. The patients' occupational status and daily activities were reported. Mean total active range of motion was 42% of the contralateral healthy side. Better active mobility and higher grip strength were found when the amputation was distal to the insertion of the common flexor tendon. Mean grip and pinch strength were 80% and 65%, respectively. Fusion did not significantly influence active mobility. The mean DASH score was 22.3. In our study, 77% of the patients returned to the same job and 75% experienced cold intolerance. The majority of patients who underwent digital replantation maintain a quality of life that allows them to return to work. Fusion, especially in the thumb, can be performed with few functional consequences. Even many years after the replantation procedure, sensory recovery remains poor.
我们试图评估截肢后接受断指再植患者的长期生活质量和功能结局。对2010年1月至2016年5月间接受治疗的患者进行了一项回顾性单中心研究。对28例单指或多指截肢后成功再植的患者进行了至少2年的随访（平均4.6年），并对其进行了亲自复查。评估了总主动活动范围、握力和捏力。使用SF-36和DASH问卷评估功能结局。报告了患者的职业状况和日常活动。平均总主动活动范围为对侧健康侧的42%。当截肢部位位于屈肌总腱止点远端时，发现主动活动度更好，握力更高。平均握力和捏力分别为80%和65%。融合对主动活动度没有显著影响。平均DASH评分为22.3。在我们的研究中，77%的患者回到了原工作岗位，75%的患者有冷不耐受症状。大多数接受断指再植的患者保持着能够让他们重返工作的生活质量。融合，尤其是拇指融合，可以在几乎不影响功能的情况下进行。即使在再植手术后多年，感觉恢复仍然很差。
