Vlastou C, Earle A S
J Hand Surg Am. 1986 Jan;11(1):51-6. doi: 10.1016/s0363-5023(86)80102-2.
Similar findings in a series of seven avulsions of the thumb suggest that this injury is a well-defined entity. In all cases avulsion was the result of catching the digit in a rotating machine. In most cases a glove was worn. The usual clinical findings included extrinsic tendon avulsion from the forearm, nerve avulsion from the median nerve within the carpal tunnel, extensive arterial damage in the amputated thumb, and partial degloving of soft tissues. Successful replantation was possible in every case. We believe that vein grafts should be used routinely, anastomosed to normal distal vessels. The site of nerve injury should be identified by dissection of the median nerve within the carpal tunnel. Retrograde flaps should not be sutured for wound closure. We believe that replantation should be attempted in all cases of thumb amputation in which the part is available.
在一系列7例拇指撕脱伤中得到的类似结果表明，这种损伤是一种明确的病症。在所有病例中，撕脱伤均是手指卷入旋转机器所致。多数病例中患者戴有手套。常见的临床发现包括前臂的外在肌腱撕脱、腕管内正中神经的神经撕脱、离断拇指的广泛动脉损伤以及软组织部分脱套。每例均有可能成功再植。我们认为应常规使用静脉移植物，并与正常的远端血管吻合。应通过解剖腕管内的正中神经来确定神经损伤部位。不应缝合逆行皮瓣来闭合伤口。我们认为，对于所有拇指离断且断指尚可用的病例均应尝试进行再植。
