Mai Tuong Trong, Nguyen Thach Ngoc, Phan Thang Dzu Le, Vo Khanh Hoa, Nguyen Phi Duong
Microsurgery and Limb Reconstruction Department, Hospital for Traumatology and Orthopaedics, Ho Chi Minh City, Viet Nam.
Orthopaedic - Burn - Plastic Surgery Department, City Children's Hospital, Ho Chi Minh City, Viet Nam.
Orthop Rev (Pavia). 2024 Mar 9;16:94566. doi: 10.52965/001c.94566. eCollection 2024.
The intricate endeavor of replanting the distal phalanx of the finger remains a persistent challenge. In the pursuit of addressing this concern, microsurgical replantation procedures have been systematically examined for distal phalanx injuries encircling the distal interphalangeal (DIP) joint, conducted at the Orthopaedic Hospital situated in Ho Chi Minh City.
This investigation encompassed a cohort of 31 patients, comprising individuals with 17 instances of complete and 21 instances of incomplete amputations of the distal phalanges. The subjects' ages spanned a range from 3 to 56 years.
The study divulged that eight fingers, involving four complete amputations and four incomplete amputations, did not achieve successful outcomes. In contrast, the remaining 30 fingers exhibited survival. A meticulous long-term follow-up of 17 fingers, extending over a period exceeding six months, unveiled commendable achievements encompassing satisfactory sensory recovery, cosmetic enhancement, and the resumption of pre-injury occupational activities by the patients.
Vein anastomosis was revealed as a notably challenging aspect of the surgical procedures. In scenarios where conventional vein suturing was rendered unfeasible, the innovative recourse of one-way drainage emerged as a viable alternative.
The endeavor to replant the distal phalanx of the finger engenders a substantial level of complexity, particularly in the realm of venous anastomosis. This research underscores the need for focused efforts to address and surmount the intricacies associated with this aspect of surgical intervention.
手指远端指骨再植这项复杂的工作仍然是一项持续存在的挑战。为了解决这一问题,在胡志明市的骨科医院,针对环绕远侧指间关节(DIP)的远端指骨损伤,系统地研究了显微外科再植手术。
本研究纳入了31例患者,包括17例远端指骨完全离断和21例不完全离断的患者。受试者年龄范围为3至56岁。
研究发现,8根手指(包括4例完全离断和4例不完全离断)未获得成功结果。相比之下,其余30根手指存活。对17根手指进行了超过6个月的细致长期随访,结果显示取得了令人满意的成果,包括感觉恢复良好、外观改善以及患者恢复伤前的职业活动。
静脉吻合被证明是手术过程中一个极具挑战性的方面。在传统静脉缝合不可行的情况下,单向引流这一创新方法成为了一种可行的替代方案。
手指远端指骨再植工作存在很大的复杂性,尤其是在静脉吻合方面。本研究强调需要集中精力解决和克服与手术干预这一方面相关的复杂性。