前臂毁损性离断的保肢治疗  

Limb salvage procedures for mutilated forearm injuries

作　　者：张波[1] 宫可同[1] 韩力[1] 鲁毅军[1] 尹路[1] 徐建华[1] 曹树明[1] 齐江明 

机构地区：[1]天津医院手外科,天津300211 [2]天津医科大学研究生院

出　　处：《中华手外科杂志》2016年第2期109-111,共3页Chinese Journal of Hand Surgery

摘　　要：目的 探讨前臂毁损性离断后的保肢治疗.方法 自2012年9月至2014年10月,我们对8例前臂毁损性离断患者急诊采用前臂部分短缩再植方法进行保肢治疗.结果 术后8例患者均保肢成功,随访时间为6-24个月,根据中华医学会手外科学会上肢部分功能评定试用标准评定：优1例,良5例,差2例.1例并发动脉危象,经手术探查重新吻合血管后肢体存活;1例并发严重感染,经抗感染治疗后伤口愈合;1例并发前臂骨折不愈合,经二期植骨固定后愈合;1例并发肌腱粘连,二期行肌腱松解术.结论 对有保肢条件的前臂毁损伤应积极行保肢治疗,可取得较好疗效.Objective To report the limb salvage experience in patients with mutilated forearm severance.Methods From September 2012 to October 2014,8 severed forearms with mutilated injuries were salvaged by shortening and replantation of the forearm after emergency debridement.Results The replants survived in all 8 cases.Postoperative follow-up ranged from 6 to 24 months.Based on the evaluation criteria for the upper extremity issued by the Hand Surgery Society of the Chinese Medical Association,functions of the salvaged forearms were rated as excellent in 1 case,good in 5 cases,and poor in 2 cases.Postoperative complications included arterial crisis in 1 case that was rescued by surgical exploration and vascular reanastomosis;severe infection in 1 case that was successfully managed with antibiotics treatment;forearm fracture nonunion in 1 case that was healed with secondary fixation and bone graft;and tendon adhesion in 1 case that was treated with secondary tenolysis.Conclusion Limb-salvage procedures should be considered in mutilated forearm severance cases when conditions allow.Reasonable functional outcomes can be expected.

关 键 词：前臂 治疗结果 毁损性离断伤 保肢 

分 类 号：R658.1[医药卫生—外科学]