Mattar Tiago Guedes da Motta, Matalani Caio Felipe Araujo, Silveira Henrique Brito, Sargaço Arthur Kayano, Pessa Mariana Miranda Nicolosi, de Pontes Fernando Vicente, Wei Teng Hsiang, Mattar Rames, de Rezende Marcelo Rosa
Universidade de São Paulo, Faculdade de Medicina, Instituto de Ortopedia e Traumatologia IOT HCFMUSP, Grupo de Cirurgia da Mão e Microcirurgia Reconstrutiva, São Paulo, SP, Brazil.
Universidade de São Paulo, Faculdade de Medicina, São Paulo, SP, Brazil.
Acta Ortop Bras. 2024 Aug 2;32(3):e274165. doi: 10.1590/1413-785220243203e274165. eCollection 2024.
This article presents a retrospective cohort study analyzing patients from IOT-FMUSP who underwent replantation or revision amputation procedures for traumatic thumb amputation between 2013 and 2020.
The study included 40 patients in the replanted group and 41 patients in the amputed group. The patients were divided according to the level of amputation and their medical records were analyzed.
A total of 81 patients with digital amputation were analyzed, consisting of 79 males and 2 females, with mean ages of 43 and 49 for the amputed and replanted groups, respectively. According to the Biemer classification, 28.4% had proximal amputation, while 71.6% had distal amputation. The most common occupation was bricklayer (19.75%), and 80.24% were manual workers. Of the patients, 65% returned to their previous work, with 77.77% of them having amputation on their non-dominant hand, mostly caused by circular saw accidents (77.77%). The replantation success rate was 78%, with an average ischemia time of 9 hours and door-to-room time of 2 hours.
the study findings revealed that traumatic thumb amputation predominantly affects working-age males with a low education level and the success rate of replantation was high in this ischemia time and door-to-room conditions.
本文呈现一项回顾性队列研究，分析2013年至2020年间在IOT - FMUSP接受创伤性拇指断指再植或翻修截肢手术的患者。
该研究包括40例再植组患者和41例截肢组患者。根据截肢水平对患者进行分组，并分析他们的病历。
共分析了81例手指截肢患者，其中男性79例，女性2例，截肢组和再植组的平均年龄分别为43岁和49岁。根据比默分类法，28.4%为近端截肢，而71.6%为远端截肢。最常见的职业是砖匠（19.75%），80.24%为体力劳动者。在这些患者中，65%恢复了之前的工作，其中77.77%在非优势手截肢，主要由圆锯事故导致（77.77%）。再植成功率为78%，平均缺血时间为9小时，门到手术室时间为2小时。
研究结果显示，创伤性拇指截肢主要影响教育程度较低的劳动年龄男性，在这种缺血时间和门到手术室条件下，再植成功率较高。
