323例末节断指再植的临床经验

Clinical experience on 323 cases of finger distal segment replantation

目的总结末节断指再植的临床经验.方法采用静脉动脉化、血管移植、扩大近端骨髓腔的经骨髓腔静脉回流等方法治疗末节断指.结果再植323例,其中成活314例,成活率97.1%.术后随访3个月～5年,根据中华医学会手外科学会断指再植功能评定试用标准,优217例,良89例,差8例.结论采用静脉动脉化、血管移植、扩大近端骨髓腔的经骨髓腔静脉回流等再植方法不仅可以扩大再植适应证,提高断指再植成活率,而且有良好的外形及功能.

Objective To summarize clinical experience on finger distal segment replantation. Methods With venous arterialization, vascular transplantation and proximal medullary enlargement for venous drainage, the replantation was performed. Results 323 cases were undergone finger distal segment replantation,of which 314 survived （97. 1% ）. All were followed up for 3 months -5 years.According to replanted finger function scoring system of Society of Hand Surgery of Chinese Medical Association,the function was excellent in 217 cases, good in 89, and fair in 8. Conclusions With venous arterialization,vascular transplantation and proximal medullary englargement for venous drainage, the replantation indication can be expanded,the survival rate can be improved and good appearance and function can be attained.