Urbaniak J R, Roth J H, Nunley J A, Goldner R D, Koman L A
J Bone Joint Surg Am. 1985 Apr;67(4):611-9.
We reviewed fifty-nine consecutive cases of patients who had replantation of a single finger (excluding the thumb) after traumatic amputation, with an average follow-up of fifty-three months. Fifty-one (86 per cent) of the replanted fingers survived. Survival was found to be affected by the age of the patient, the number of vessels that were anastomosed, and the replantation experience of the surgeons. The survival rate was not affected by the gender of the patient, the mechanism of injury, or which finger was amputated. As compared with survival only, the functional results were most dependent on the level of amputation. The proximal interphalangeal joint in amputated fingers that were replanted distal to the insertion of the flexor superficialis tendon had an average range of motion of 82 degrees after replantation, while those amputated proximal to the insertion had an average range of motion of only 35 degrees after replantation. The average operating time was six hours and ten minutes, and the average time until the patient returned to work was 2.3 months. Based on this experience, it is our opinion that replantation of a single finger that was amputated distal to the insertion of the flexor superficialis tendon is justified, but that replantation of a single finger that was amputated proximal to this insertion is seldom indicated.
我们回顾了59例因创伤性截肢后进行单指（不包括拇指）再植的连续病例，平均随访53个月。51例（86%）再植手指存活。发现存活情况受患者年龄、吻合血管数量以及外科医生的再植经验影响。存活率不受患者性别、损伤机制或被截肢手指的影响。与仅存活情况相比，功能结果最取决于截肢平面。在屈指浅肌腱止点远侧被截肢的再植手指，其近端指间关节再植后的平均活动范围为82度，而在屈指浅肌腱止点近侧被截肢的手指，再植后的平均活动范围仅为35度。平均手术时间为6小时10分钟，患者恢复工作的平均时间为2.3个月。基于这一经验，我们认为，在屈指浅肌腱止点远侧被截肢的单指再植是合理的，但在该止点近侧被截肢的单指很少需要再植。
