利用显微外科技术进行创伤修复（附124例）

RESTORATION OF INJURIES WITH MICROSURGICALTECHNIQUES:A REPORT OF124 CASES

１９９０～１９９３年利用显微外科技术对１２４例各类创伤进行了修复。结果：拇指再造的１４例经５个月至２年随访，再造拇指的外观、感觉及对掌功能均达到要求；断指再植７０指，成活６２指；断臂再植４例、断掌再植５例、断腕再植４例，均成活；带血管蒂的骨移植修复大段骨缺损７例，６例成活；带血管蒂的游离皮瓣移值修复大面积皮肤缺损９例全成活；复杂创伤合并重要血管损伤的３６例，其中得到及时修复的１６例均挽救了肢体。认为：利用显微外科技术修复创伤，可更多地保留肢体和恢复一定的功能。但显微外科也有其局限性和特殊性，因此，手术适应症的选择和术后处理至关重要。

Various injuries were repaired with microsurgical techniques in 124 cases from 1990 to 1993.Of them,14 cases undergoing thumb reconstruction were followed up for 5 months to 2 years and had a satisfactory appearances,sensation and opposing function.seventy cases were treated with replantation of severed fingers,among which 62 fingers survived.Out of the careful treatment with replantation and attendance,4 cases of severed wirst replantation,5 severed palm replantation and 4 svered arm replantation were rejoined successfully.Defects of a section of long bone were repaired by pediculated bone grafting in 7 cases;6 of them survived.Free skin flap grafting with vascular pedicle was used to repair extensive skin defects in 9 cases;they all survivde.Sixteen of 36 cases with complicated injuries accompanied by main vascular and nerve injuries were all treated timely with the microsurgical techmiques,so their limbs were saved.The authors think that application of the microsurgical techques to treat injuries can save as many limbs as possible and restore their function,but microsurgery has some limitations and particularity,therefore the choice of the indications and postoperative treatment are very important.