利用虎口动脉和邻指动脉转位重建拇指旋转撕脱离断指体血运的疗效比较  

Clinical outcome contrast of using Hukou artery and ulnar proper digital arteries of index finger translocation to reconstruct artery supply in replanting of rotated and avulsed thumbs

作　　者：刘育杰[1] 丁小珩[2] 杜丽[2] 刘元富[2] 刘春雷[2] 屈志刚[2] 曹学成[1] 

机构地区：[1]济南军区总医院骨创伤外科,济南250031 [2]解放军401医院

出　　处：《中华显微外科杂志》2013年第4期335-338,共4页Chinese Journal of Microsurgery

基　　金：中国博士后科学基金资助项目（2012M521930）

摘　　要：目的探讨利用虎口动脉和示指尺侧指同有动脉转位治疗拇指旋转撕脱离断的临床疗效差异、，方法2011年1月至2012年5月，对16例拇指旋转撕脱离断患者分别采用虎口动脉转位（A组，8例）和示指尺侧指吲有动脉转位（B组，8例）重建离断拇指动脉供血。A组：男6例，女2例；年龄（27．0±9．5）岁。致伤原因：机器绞伤7例，车祸伤1例。受伤至手术时间为（6．1±3．1）h。离断平面：近节指骨基底部5例，掌指关节平面3例。B组：男5例，女3例；年龄（29．7±13．7）岁。致伤原因：机器绞伤6例，绳索绞伤2例。离断平面：受伤至手术时间为（7．1±2．2）h。近节指骨基底部4例，掌指关节平面4例；静脉、神经、肌腱修复按照常规进行。结果A组、B组共16例断指全部成活。A、B组手术时间分别为（3．2±0．8）h及（5．3±0．6）h，差异有统计学意义（P〈0。05）。所有患者均获随访，随访时间3～10个月（平均6．9个月）。按中华医学会手外科学会断指再植功能评定使用标准，A、B组优良率均为75．0％，差异无统计学意义（P〉0．05）。结论利用虎口动脉和示指尺侧指固有动脉转位治疗拇指旋转撕脱两种方法疗效相近，但前者操作更简便，创伤更小，是一种较好的再植方法。Objective To compare the clinical outcomes of using the Hukou artery and ulnar proper digital artery of index finger translocation to reconstruct artery supply in replanting of rotated and avulsed thumb. Methods From January 2011 to May 2012, replantation surgery were carried out in 16 patients with rotated and avulsed injury of thumb. In group A, all cases were replanted by Hukou artery translocation, in which 6 males and 2 females and （27.0 ±9. 5 ） years old in average. The causes of injury were machine strangulation （7 patients） and traffic accident （ 1 patient）. The average time from injury to operation were （ 6. 1 ＋ 3. 1 ） hours. The amputed level were at the base of proximal phalanx （5 patients） and metacarpophalangeal joint （3 patients）. In group B, all patients were replanted using ulnar proper digital artery of index finger translocation, in which 5 males and 3 females and （29. 7 ±13.7） years old in average. The causes of injury were machine strangulation （6 patients） and cord wring injury （2 patient）. The average time from injury to operation were（ 7. 1 ±2. 2 ）hours. The amputed level were at the base of proximal phalanx （4 patients） and metacarpophalangeal joint （4 patients）. Results The operation time were （ 3.2± 0. 8 ） minutes in group A and （ 5.3± 0. 6 ） minutes in group B. All fingers were survived in both groups. All patients were followed up 3-10 months （6. 9 months on average ）. Excellent rate reached 75.0% in group A and 75.0% in group B according to Criterion on Functional evaluation on Finger Reconstruction issued by Chinese society of hand surgery. There were significant differences between the two groups in operation time （ P 〈 0. 05 ）, and without differences in excellent rate （ P 〉 0. 05 ）. Conclusion There aresame outcome by using the Hukou artery and ulnar proper digital artery of index finger to reconstruct artery supply in replantation of rotated and avulsed thumb. However, using the Hukou artery transloeat

关 键 词：拇指 再植 离断 重建 虎口动脉 

分 类 号：R658.2[医药卫生—外科学]