Matsuda M, Kato N, Hosoi M
J Trauma. 1981 May;21(5):403-6. doi: 10.1097/00005373-198105000-00014.
We performed three replantations at the upper arm: two patients had severely crushed arms and one patient was at advanced age (50 years). One replanted arm was reamputated because of severe neuralgia 1 year, 3 months after replantation. In the other two cases, sensation was recovered to fingertips and powerful motion of the elbow joint was gained. However, pinch or grasp was impossible because of insufficient reinnervation to the extensor muscles. In replantation at the proximal region, recovery of motor function generally tends to be poor especially in a crush injury or in the case of advanced age. Therefore we consider that the decision about arm replantation at the upperarm region should be made more strictly than with a distal amputation.
我们在上臂进行了3例再植手术:2例患者手臂严重挤压伤,1例患者年龄较大(50岁)。1例再植手臂在再植后1年3个月因严重神经痛而再次截肢。在另外2例中,感觉恢复至指尖,肘关节获得了有力的活动。然而,由于伸肌再支配不足,无法进行捏握或抓握动作。在近端区域进行再植时,运动功能的恢复通常较差,尤其是在挤压伤或患者年龄较大的情况下。因此,我们认为,与远端截肢相比,在上臂区域进行手臂再植的决策应更加严格。