带有瘀癍的挤轧旋转撕脱性断指再植24例36指临床分析  

Clinical analysis of 24 cases of 36 fingers with ecchymosis and extruded rotated avulsion replantation

作　　者：王光楠 陈艳 魏永兴 金敬一 WANG Guangnan;CHEN Yan;WEI Yongxing(Department of Orthopedics,968 Hospital of Surport Force of PLA,Liaoning,Jinzhou,121001,China)

机构地区：[1]中国人民解放军联勤保障部队第968医院骨二科,辽宁锦州121001

出　　处：《实用手外科杂志》2020年第2期189-190,193,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨带有瘀癍的挤轧旋转撕脱性断指再植的适应证和手术方法。方法2009年4月-2019年4月对24例36指带有瘀癍的挤轧旋转撕脱性断指,根据其污染情况、血管神经、软组织损毁情况,I期急诊采取血管神经移植或转位修复手术,重建断指血供;对软组织缺损分别采取Ⅰ期皮瓣、植皮或Ⅱ期植皮修复等不同术式。结果术后经2~18个月的随访,成活33指,成活率91.6%。结论在扎实的显微外科微血管吻合技术保障下,根据伤情设计不同手术方法,可大大提高带有瘀癍的挤轧旋转撕脱性断指再植的成功率。Objective To explore the indications and surgical methods of extruded rotated avulsion replantation with petechiae.Methods From April 2009 to April 2019,36 cases of 24 patients were treated with extruded r rotated avulsion severed fingers.According to the situation of contamination,vascular nerve and soft tissue damage,nerve and vascular transplantation or transposition was performed in the 1 st stage emergency operation to reconstruct and restore the blood supply of severed fingers.For soft tissue defects,the 1 st stage flap,skin graft or the 2 nd stage skin graft were performed respectively.Results After 2-18 months of follow-up,33 severed fingers survived,the survival rate was 91.6%.Conclusion Under the safeguard of solid microsurgical microvascular anastomosis technique,different surgical methods can be designed according to the injury condition,which can greatly improve the success rate of the extruded rotatory avulsion replantation with petechiae.

关 键 词：瘀癍 挤轧旋转撕脱性 断指再植 

分 类 号：R658.1[医药卫生—外科学]