Beris A E, Soucacos P N, Malizos K N, Xenakis T A
Department of Orthopaedic Surgery, University of Ioannina, School of Medicine, Greece.
Microsurgery. 1994;15(7):459-63. doi: 10.1002/micr.1920150705.
Fourteen patients with ring avulsion injuries were treated at the University of Ioannina from 1982 to 1991. One patient was classified as Urbaniak class II, and microsurgical repair produced good functional results. The remaining 13 patients had class III injuries. Six of these patients had class IIIa injuries, defined as skin avulsions at the level of the proximal phalanx, amputation at the distal interphalangeal joint with an intact flexor digitorum superficialis. Replantation was successful in four patients. Seven patients had class IIIb injuries, defined as skin avulsion and complete amputation at the level of the proximal phalanx, with severance of both flexor tendons. Replantation was successful in four patients, with compromised functional results in two. Primary surgical repair is the treatment of choice for class II and IIIa injuries which usually have rewarding results. Although there may be some functional compromise following replantation in class IIIb injuries in adults, we suggest that microsurgical replantation should also be attempted after the prognosis is clearly explained to the patient.
1982年至1991年期间，约阿尼纳大学共治疗了14例环形撕脱伤患者。其中1例患者被归类为乌尔巴尼亚克II级，经显微外科修复后功能恢复良好。其余13例患者为III级损伤。其中6例为IIIa级损伤，定义为近端指骨水平的皮肤撕脱、远侧指间关节离断且指浅屈肌完整。4例患者再植成功。7例患者为IIIb级损伤，定义为近端指骨水平的皮肤撕脱和完全离断，同时两根屈肌腱均断裂。4例患者再植成功，2例功能恢复欠佳。对于II级和IIIa级损伤，一期手术修复是首选治疗方法，通常效果良好。虽然成人IIIb级损伤再植后可能会出现一些功能受限，但我们建议在向患者清楚解释预后情况后，也应尝试进行显微外科再植。
