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吻合掌侧静脉及保留指甲的指尖再植
Hits: 2389   Download times: 1627   Received:December 25, 2012    
作者Author单位UnitE-Mail
王相 WANG Xiang 宁波明州医院手外科, 浙江 宁波 315100 Department of Hand Surgery, Ningbo Mingzhou Hospital of Yinzhou, Ningbo 315100, Zhejiang, China  
张威凯 ZHANG Wei-kai 宁波明州医院手外科, 浙江 宁波 315100 Department of Hand Surgery, Ningbo Mingzhou Hospital of Yinzhou, Ningbo 315100, Zhejiang, China zhang71511@163.com 
尹绍猛 YIN Shao-meng 宁波明州医院手外科, 浙江 宁波 315100 Department of Hand Surgery, Ningbo Mingzhou Hospital of Yinzhou, Ningbo 315100, Zhejiang, China  
王海兵 WANG Hai-bing 宁波明州医院手外科, 浙江 宁波 315100 Department of Hand Surgery, Ningbo Mingzhou Hospital of Yinzhou, Ningbo 315100, Zhejiang, China  
何涛 HE Tao 宁波明州医院手外科, 浙江 宁波 315100 Department of Hand Surgery, Ningbo Mingzhou Hospital of Yinzhou, Ningbo 315100, Zhejiang, China  
龚永清 GONG Yong-qing 宁波明州医院手外科, 浙江 宁波 315100 Department of Hand Surgery, Ningbo Mingzhou Hospital of Yinzhou, Ningbo 315100, Zhejiang, China  
朱国明 ZHU Guo-ming 宁波明州医院手外科, 浙江 宁波 315100 Department of Hand Surgery, Ningbo Mingzhou Hospital of Yinzhou, Ningbo 315100, Zhejiang, China  
毛根莲 MAO Gen-lian 宁波明州医院手外科, 浙江 宁波 315100 Department of Hand Surgery, Ningbo Mingzhou Hospital of Yinzhou, Ningbo 315100, Zhejiang, China  
胡明星 HU Ming-xing 宁波明州医院手外科, 浙江 宁波 315100 Department of Hand Surgery, Ningbo Mingzhou Hospital of Yinzhou, Ningbo 315100, Zhejiang, China  
李建 LI Jian 宁波明州医院手外科, 浙江 宁波 315100 Department of Hand Surgery, Ningbo Mingzhou Hospital of Yinzhou, Ningbo 315100, Zhejiang, China  
期刊信息:《中国骨伤》2013年26卷,第8期,第639-641页
DOI:10.3969/j.issn.1003-0034.2013.08.007


目的: 探讨手指指尖离断的治疗方法及临床效果。

方法: 2007年10 月至2011年6月治疗13例18指指尖离断患者,其中男9例,女4例;年龄17~45岁,平均26岁。伤后至就诊时间30 min~5 h,断指缺血时间1.5~7 h,均为常温保存。采用吻合掌指静脉及保留指甲的方法进行再植。

结果: 13例18 指断指均成活并获随访,术后无血管危象发生。随访时间为3~24个月,平均14个月。患指外形及长度与健指相似,指甲平整,关节活动良好,触、痛觉恢复,两点辨别率3~6 mm,平均5 mm.根据中华医学会手外科学会断指再植功能评定标准评定,优14指,良3指,差1指。

结论: 采用吻合掌侧静脉及保留指甲的方法进行指尖再植,不仅可以提高断指成活率还可以恢复良好的外观及功能,是一种理想的方法。
[关键词]:指损伤  软组织损伤  再植术  修复外科手术
 
Fingertip replantation with anastomosis of palm vein and retaining the nail
Abstract:

Objective: To study the replantation methods and clinical results of amputated fingertip.

Methods: From October 2007 to June 2011,18 fingers of 13 cases were replanted with anastomosis of palm vein and retaining the nail, including 9 males and 4 females,with an average age of 26 years old ranging from 17 to 45 years old. The time from injury to therapy was from 30 min to 5 h, time of broken finger ischemia was from 1.5 to 7 h. All broken fingers were preservation under normal temperature.

Results: All fingers were survived, no vascular crisis happened. All cases were followed up from 3 to 24 months with an average of 14 months. The length and shape of replanted fingers were similar to that of the healthy side. The new nails were smooth, the function was perfect,the sense of pain and touched sensation had been recovered. Their two-piont discriminations ranged from 3 to 6 mm with an average of 5 mm. According to the assessment standard of Chinese Medical Association of Hand Surgery,the results were excellent in 14 cases,good in 3 cases,poor in 1 case.

Conclusion: Fingertip replantation with anastomosis of palm vein and retaining the nail is regained satisfactory appearance and function of the digits with a high survival rate.
KEYWORDS:Finger injuries  Soft tissue injuries  Replantation  Reconstructive surgical procedures
 
引用本文,请按以下格式著录参考文献:
中文格式:王相,张威凯,尹绍猛,王海兵,何涛,龚永清,朱国明,毛根莲,胡明星,李建.吻合掌侧静脉及保留指甲的指尖再植[J].中国骨伤,2013,26(8):639~641
英文格式:WANG Xiang,ZHANG Wei-kai,YIN Shao-meng,WANG Hai-bing,HE Tao,GONG Yong-qing,ZHU Guo-ming,MAO Gen-lian,HU Ming-xing,LI Jian.Fingertip replantation with anastomosis of palm vein and retaining the nail[J].zhongguo gu shang / China J Orthop Trauma ,2013,26(8):639~641
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