Duffy F J, Concannon M J, Gan B S, May J W
Medical City Dallas, TX 75230, USA.
Ann Plast Surg. 1998 May;40(5):538-41. doi: 10.1097/00000637-199805000-00018.
It is generally accepted that replanted digits surviving at least 1 week following surgery rarely succumb to ischemic necrosis. Presented here are 2 patients who experienced late digital replantation failure. The first patient is an 8-year-old boy who had his index finger replanted at the proximal phalangeal level. After 16 days of viability, the replanted digit became swollen and subsequently necrosed. The second patient is a 35-year-old man with a history of smoking and intravenous drug use who underwent replantation of his avulsed thumb at the metacarpophalangeal joint. The replanted thumb was viable at the 2-week follow-up, but began to show ischemic changes at 3 weeks and eventually required revision amputation at the interphalangeal level. Both of these patients demonstrate late digital replantation failure--an unusual and poorly understood phenomenon. A discussion of possible risk factors and potential pathophysiology is presented.
一般认为，再植手指在术后至少存活1周的情况下很少会因缺血性坏死而失败。本文介绍了2例晚期手指再植失败的患者。首例患者为一名8岁男孩，其示指在近节指骨水平进行了再植。在存活16天后，再植手指肿胀，随后坏死。第二例患者是一名35岁男性，有吸烟和静脉吸毒史，其拇指在掌指关节处离断后进行了再植。再植拇指在2周随访时存活，但在3周时开始出现缺血改变，最终需要在指间水平进行翻修截肢。这两名患者均表现为晚期手指再植失败——这是一种不常见且了解甚少的现象。本文对可能的危险因素和潜在的病理生理学进行了讨论。
