异位再植在拇指毁损伤修复中的应用  

Clinical application of ectopic replantation in repair of thumb and finger damage

作　　者：李高辉[1] 晁春艳 路闯[1] 刘文卉[1] LI Gaohui;CHAO Chunyan;LU Chuang(Department of Bone Microsurgery,Joint Logistic Support Force 990 Hospital,Zhumadian,Henan,463000,China)

机构地区：[1]中国人民解放军联勤保障部队第990医院显微外科,河南驻马店463000 [2]黄淮学院医学院,河南驻马店463000

出　　处：《实用手外科杂志》2022年第4期515-517,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨拇手指毁损伤中一期利用废弃指异位再植再造重建毁损拇指的手术方法和临床疗效。方法2017年3月-2021年1月,对12例拇手指毁损伤患者采用示指异位再植再造拇指4例,中指异位再植再造拇指4例,环指异位再植再造拇指3例,小指异位再植再造拇指1例。结果术后12例完全成活11例,部分坏死残端修整1例。术后随访9~18个月,再造拇指感觉恢复良好,伸屈功能良好。采用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7例,良3例,可2例。结论拇指毁损伤的复杂断指再植再造方法各异,正确判断伤情,将异位再植再造拇指放在首位,术后通过快速康复技术可获得满意的临床疗效。Objective To investigate the surgical method and clinical effect of the first stage of the reconstruction of the damaged thumb with abandoned finger ectopic replantation.Methods In 12 cases of pitchman's destruction injury,the thumb was reconstructed by ectopic replantation of the index finger in 4 cases,the middle finger in 4 cases,the ring finger in 3 cases and the little finger in 1case.Postoperative follow-up through outpatient and wechat.Results Eleven of 12 cases were completely alive,and 1 case was trimmed with partially necrotic stump.All the patients were followed up for 9-11 months after surgery,the feeling of the retransplanted fingers recovered well,and the extension and flexion function were good.Conclusion Throwing the finger accounts for about 70%of the total hand function,and the complicated method of thumb replantation and replantation can correctly judge condition,and the finger should be the first place in the primary reconstruction of thumb replantation,and satisfactory results can be obtained by rapid rehabilitation techniques after surgery.

关 键 词：毁损 移位再植 修复重建 快速康复 

分 类 号：R658.1[医药卫生—外科学]