May J W, Toth B A, Gardner M
J Hand Surg Am. 1982 Mar;7(2):161-6. doi: 10.1016/s0363-5023(82)80081-6.
Microvascular replantation of digits distal to the proximal interphalangeal joint were reviewed in 24 digits in 18 patients. Of the 24 digits studied, five were seen in patients who had a single digit amputated and replanted, 10 were seen in patients who had multiple distal digital amputations and replantations, and eight were seen in patients who had other proximal digital replantations or other associated hand injuries in addition to the distal replantations. Survival rate in this study was 96%, and the mean active range of motion at the proximal interphalangeal joint was 95 degrees with 8.9 degrees active motion at the distal interphalangeal joint. Two-point discrimination averaged 11 mm, and all patients had some cold intolerance. The nine students in this study required a mean 1.7 months to return to school; nine patients were workers and required a mean of 5.1 months to return to work. Acceptance for the procedures was overwhelmingly good. Replantation of an amputated digit distal to the proximal interphalangeal joint in selected cases can be a worthwhile procedure.
对18例患者的24个近节指间关节远端手指进行了微血管再植术回顾。在研究的24个手指中,5个见于单个手指离断并再植的患者,10个见于多个远端手指离断并再植的患者,8个见于除远端再植外还进行了其他近端手指再植或伴有其他手部相关损伤的患者。本研究中的存活率为96%,近节指间关节的平均主动活动范围为95度,远节指间关节的主动活动为8.9度。两点辨别觉平均为11毫米,所有患者均有一定程度的冷不耐受。本研究中的9名学生平均需要1.7个月返校;9名患者为工人,平均需要5.1个月重返工作岗位。对这些手术的接受度总体良好。在特定病例中,对近节指间关节远端离断手指进行再植可能是一项值得进行的手术。