Demiri E, Bakhach J, Tsakoniatis N, Martin D, Baudet J
Department of Plastic, Reconstructive, Hand Surgery, and Microsurgery, Hôpital du Tondu, Bordeaux, France.
J Reconstr Microsurg. 1995 Mar;11(2):113-22; discussion 122-3. doi: 10.1055/s-2007-1006518.
Bone growth and the development of epiphyseal plates are disturbed after the replantation of amputated extremities in children, but the potential for continued skeletal growth is almost always maintained in the replanted part. In this reported series of 12 children, all younger than 15 years old, 13 amputated parts of the upper limb have been successfully replanted. After long-term follow-up (from 21 to 216 months), bone growth of the replanted parts was clinically and radiologically evaluated. Two different growing segments were distinguished: the proximal bone segment, directly injured from the initial trauma, and the distal replanted part. Average longitudinal growth recorded was 94.5 percent and 92.7 percent, respectively. Two young patients demonstrated overgrowth of the proximal bone segment, which attained 110 percent and 118 percent of expected growth. Although it is difficult to determine all the parameters affecting the prognosis of post-traumatic reactions in growing cartilaginous plates, the level of amputation is considered to be a significant prognostic factor for the epiphyseal growth of the replanted part.
儿童断肢再植后，骨生长及骨骺板发育会受到干扰，但再植部位几乎总能保持持续骨骼生长的潜力。在本报道的12例均未满15岁的儿童系列中，13个上肢断肢已成功再植。经过长期随访（21至216个月），对再植部位的骨生长进行了临床和放射学评估。区分出两个不同的生长节段：近端骨节段，直接因初始创伤而受损；远端再植部位。记录的平均纵向生长分别为94.5%和92.7%。两名年轻患者出现近端骨节段过度生长，分别达到预期生长的110%和118%。虽然难以确定影响生长软骨板创伤后反应预后的所有参数，但截肢水平被认为是再植部位骨骺生长的一个重要预后因素。
