Department of Orthopedics, Shanghai Sixth People's Hospital East Affiliated to Shanghai University of Medicine & Health Sciences, No. 222 Huanhu Xisan Road, Shanghai, 201306, China.
Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
J Orthop Surg Res. 2020 Mar 11;15(1):104. doi: 10.1186/s13018-020-01621-w.
Mangled finger with impaired arteria digitalis communis remains to be a challenge for replantation surgery due to the limited amount of tissue to work with.
Out of 554 hands with total finger amputations treated by replantation of finger/fingers from July 2012 to June 2018, there were 7 cases of damaged arteria digitalis communis, all of which were replanted by anastomosing distal adjacent radial/ulnar digital artery to distal end of ulnar/radial digital artery of amputation finger, and 2 veins were anastomosed for each finger. A skin pedicle was made by suturing both dorsal and palmar skin of adjacent fingers, and detachment was performed 4 weeks postoperatively.
The survival rate was 100%. Mean total active motion was 191.4° (ranging from 170 to 220°). Mean 2-point discrimination was 8 mm static (ranging from 6 to 11 mm), and mean grip strength was 35.3 kg (range, 29 to 40 kg).
Based on our experience, cross-finger revascularization is an effective and safe alternative for mangled finger salvage when arteria digitalis communis is damaged, and good functional prognosis can be expected.
由于可供操作的组织有限，伴有固有动脉损伤的毁损性手指仍然是再植手术的挑战。
2012 年 7 月至 2018 年 6 月，共有 554 例完全性手指离断患者接受再植治疗，其中 7 例固有动脉损伤，均采用吻合断指相邻的桡/尺侧指动脉的远断端至离断指的尺/桡侧指动脉，每根手指吻合 2 根静脉。通过缝合相邻手指的背侧和掌侧皮肤来制作皮蒂，并在术后 4 周进行分离。
再植手指全部存活，成活率为 100%。平均总主动活动度为 191.4°（范围 170°至 220°）。两点分辨觉平均为静态 8mm（范围 6mm 至 11mm），平均握力为 35.3kg（范围 29kg 至 40kg）。
根据我们的经验，当固有动脉损伤时，指侧方血管吻合是一种有效且安全的毁损性手指再植方法，可以获得良好的功能预后。
