Touliatos A S, Soucacos P N, Beris A E, Zoubos A B, Koukoubis T H, Makris H
Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Greece.
Acta Orthop Scand Suppl. 1995 Jun;264:19-22. doi: 10.3109/17453679509157159.
We present our experience from 108 partially or totally amputated digits in 87 patients which were replanted or revascularized successfully by the Orthopaedic Microsurgical Team at the University of Ioannina Medical School in Greece, during the period from 1978 to 1994. The majority of the patients were men involved in occupational accidents. Bone shortening always preceded the osteosynthesis and the vessel anastomosis, and most of the available methods for osteosynthesis were used, including small plates, single lag screws, crossed Kirschner wires, a combination of intraosseus cerclage wires and Kirschner wires, and intramedullary Kirschner wires. Our findings suggest that the most appropriate method for bone fixation in digital replantation is the insertion of one intramedullary Kirschner wire, supplemented by another wire which is inserted at the end of the procedure. This technique was found superior for the following reasons: 1) it's simplicity and the speed of the technique reduced the ischemic time; (2) less bone exposure was required; (3) less skeletal mass was needed for fixation; and (4) prior to the insertion of the second Kirschner wire, rotation of the replanted part was possible if it was necessary to re-align the vessels or to correct any rotational deformity.
我们介绍了1978年至1994年期间，希腊约阿尼纳大学医学院骨科显微外科团队成功再植或进行血管重建的87例患者的108个部分或完全离断手指的经验。大多数患者为男性，因职业事故受伤。骨缩短总是先于骨固定和血管吻合进行，并且使用了大多数可用的骨固定方法，包括小钢板、单枚拉力螺钉、交叉克氏针、骨内环扎钢丝与克氏针联合使用以及髓内克氏针。我们的研究结果表明，手指再植术中最适合的骨固定方法是插入一根髓内克氏针，并在手术结束时再插入另一根克氏针作为补充。该技术被认为具有以下优势：1）其操作简单且速度快，减少了缺血时间；（2）所需的骨暴露较少；（3）固定所需的骨量较少；（4）在插入第二根克氏针之前，如果有必要重新对齐血管或纠正任何旋转畸形，再植部分可以旋转。
