Cheng S L, Chuang D C, Tung T C, Wei F C
Department of Plastic and Reconstructive Surgery, College of Medicine, Chang Gung University, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC.
Ann Plast Surg. 1998 Dec;41(6):662-6. doi: 10.1097/00000637-199812000-00014.
In avulsion amputations of the digits, soft-tissue injuries are extensive and often require tendon, nerve, and vessel transfers or grafts. The functional results of such digital replantations are frequently less than ideal. Therefore, avulsion amputation of a single digit proximal to the insertion of the flexor digitorum superficialis has been a contraindication to replantation, because the anticipated poor functional result may interfere with overall hand function, and is not worth the sacrifice of a tendon, nerve, or vessel from another digit or transfer. The authors report a patient with avulsion amputation of the middle finger at the proximal interphalangeal joint. The digit was replanted successfully without any tissue transfers other than a radial digital artery from the ring finger. The functional results were good, and the authors believe that good functional and cosmetic results can be achieved in select patients with isolated digital avulsions, provided that an experienced hand microsurgeon and a skillful hand therapist are available for a compliant patient.
在手指撕脱性离断伤中，软组织损伤广泛，通常需要进行肌腱、神经和血管移植或转位。此类断指再植的功能结果往往不尽人意。因此，在指浅屈肌附着点近端的单指撕脱性离断一直被视为再植的禁忌证，因为预期的功能结果不佳可能会影响手部整体功能，且不值得牺牲另一手指的肌腱、神经或血管进行移植或转位。作者报告了1例中指近节指间关节处撕脱性离断的患者。除了取自环指的一条指桡侧动脉外，未进行任何组织移植，断指再植成功。功能结果良好，作者认为，对于部分单纯手指撕脱伤患者，只要有经验丰富的手部显微外科医生和技术娴熟的手部治疗师，且患者配合，就能获得良好的功能和外观效果。
