电锯导致拇指不全离断伤特点及手术方式探讨

The Feature and the Ways of Surgery on Thumb Wound of Incomplete Split Caused by Electric Saw

目的全面了解拇指不全离断伤特点,根据损伤情况不同采用不同手术方式。方法和结果收治病人6例,2例因拇指损毁严重,无法修复,实施截指手术;2例术中实施拇指主要动脉及指背静脉吻合,屈肌腱、伸肌腱重建而保留拇指;2例虽然皮肤、肌腱、骨、神经损毁较重,但拇指主要动脉一支或侧支循环保存,彻底清创重建术后拇指成活。结论电锯对拇指皮肤、肌腱、骨质、血管及神经损毁严重,有严重缺损,实施Ⅰ期有效手术可以挽救在手的功能中占有重要地位的拇指。

Objective Understand overall the feature of wound of incomplete split, use different way of surgery according to the degree of wound. Methods and Results Six examples, two were cut off because their thumbs were seriously woundedand cannot be repaired.Two were reserved by implementing anastomosis of main artery and vein in the back of thumb and rebuilding of extensor tendon and profundus. The last two were survived after meding thoroughly and rebuilding, because one of main artery in the thumb or side branch cycle was reserved although their skin tendon bone nerve were seriously injuried. Conclusion Although thumb skin tendon bone blood vessel and nerve were seriously injuried, early surgery can remedy the thumbs which have important fimction.