指尖冲压性断指再植效果

Observation on the outcome in re-transplantation of crushing severed fingertips of 63 cases

目的总结指尖冲击性离断的治疗效果和经验。方法对63例79指指尖冲击性离断指进行再植。吻合指固有动脉末端或指动脉弓分支或指固有动脉终末端与指动脉弓分支吻合,或动静脉转流,尽可能多吻合指掌侧静脉,对各类型平面的指尖离断的断指均进行再植。术后随访1～27个月。结果各型成活率分别为:Ⅰ型86.6%,Ⅱ型77.4%,Ⅲ型50.0%。结论只要冲压性离断的指体仍较完整,清创时能找到可供吻合的血管,应予以再植。高质量的血管吻合技术和良好的静脉血回流是保证再植成功的关键。

Objective To summrize treatment experience and outcome in re-transplantation of crushing severed fingertips.Methods The 79 crushing severed fingertips of 63 patients had been replanted from July, 2000 to September, 2004. The anastomotic procedure of arteria were as follows: anastomosis of the terminal branches of the digital artery,or of the branches of the terminal digital arterial arch. The terminal braches had been done with the branches of arteiral arch, and arteriovenous anastomosis. The superficial palmar digital veins were anastomosed as much as possible. And replanted fingertips of all kinds had been studied. The postoperative follow-up period was from l to 27 months. Results The survival rate of different types: I type, was 86.6%; Ⅱ type, 77.4%;Ⅲ type,50.0%.Conclusions Crushing severed fingertip could be re-transplanted as long as the body of the crushing fingertip remained intact and the vessels for anastomosis could be found. High quality anastomosis and good venous retum are crucial to the success of crushing fingertip re-transplantation.