Braun M, Horton R C, Snelling C F
Can J Surg. 1985 Jan;28(1):72-5.
Evaluation of the functional results and complications of 100 fingertip amputations revealed no difference between the two most commonly used repairs; 52 injuries were treated by primary closure with residual viable skin flaps and 27 by split-thickness skin grafting. No decline in unfavourable functional results was found when patients evaluated 6 weeks after injury were compared to patients evaluated 42 weeks after injury, suggesting that delaying the patient's return to full activity by prolonging rehabilitation is unlikely to yield much improvement. Shortening the nerves in proximal amputations closed by residual flaps did not decrease nerve irritation. Resection of bone produced a mobile amputation-stump tip. While the mean time off work or return to full activity following skin grafting was 6 days less than it was after primary closure, the difference was not significant.
对100例指尖离断伤的功能结果和并发症进行评估后发现,两种最常用的修复方法之间并无差异;52例损伤采用带残余存活皮瓣的一期缝合治疗,27例采用中厚皮片移植治疗。将伤后6周进行评估的患者与伤后42周进行评估的患者相比较,未发现不良功能结果有所下降,这表明延长康复时间从而推迟患者完全恢复活动不太可能带来明显改善。在采用残余皮瓣闭合的近端离断伤中缩短神经并不能减轻神经刺激。切除骨头可使截肢残端末端活动。虽然植皮后的平均误工时间或恢复完全活动的时间比一期缝合后少6天,但差异并不显著。