Graham B, Adkins P, Tsai T M, Firrell J, Breidenbach W C
Division of Orthopaedic Surgery, University of Toronto, Ontario.
J Hand Surg Am. 1998 Sep;23(5):783-91. doi: 10.1016/s0363-5023(98)80151-2.
The functional outcomes of amputated arms that were either replanted or had a prosthesis were compared. In addition, factors that influenced the functional outcome of replants were evaluated. The Carroll test was used to evaluate functional capacity of 22 successful upper extremity replantations at or proximal to the wrist as well as 22 amputees (at similar levels) fitted with a variety of prosthetic devices. The outcome was excellent or good in 8 (36%) replanted limbs. This proportion was statistically higher than those grades in the prosthetic group. When the groups were more closely matched (adults with below elbow injuries), the replantation group had 6 (50%) good or excellent outcomes and the prosthetic group had none. An analysis of covariance of the replantations demonstrated a statistical association between a better outcome in younger patients with more distal injuries. This study indicates that replantation produces superior functional results compared with amputation and a prosthesis.
对接受再植手术或安装假肢的断臂功能结果进行了比较。此外，还评估了影响再植功能结果的因素。采用卡罗尔测试来评估22例成功进行的腕部或腕部近端上肢再植手术以及22例（在相似水平）装配了各种假肢装置的截肢者的功能能力。8例（36%）再植肢体的结果为优或良。这一比例在统计学上高于假肢组的等级。当两组更紧密匹配时（肘部以下损伤的成年人），再植组有6例（50%）结果为优或良，而假肢组则没有。对再植手术的协方差分析表明，年龄较小、损伤部位更远端的患者预后较好，二者之间存在统计学关联。这项研究表明，与截肢和安装假肢相比，再植手术能产生更好的功能结果。
