手指旋转撕脱性离断再植的临床研究

Clinical reasearch of replantation of rotational avulsed severed fingers

目的探讨手指旋转撕脱性离断再植方法及临床疗效。方法2007年5月-2011年9月对21例30指旋转撕脱性离断的断指进行再植，根据手指旋转撕脱离断的程度，分别采用血管移植、血管神经束转位、带血管皮瓣转移等方法重建血循环及感觉。结果30指成活29指，失败1指，成活率96．7％。术后随访20例，随访时间6个月～3年，平均1年5个月，以最后一次随访结果为准，按中华医学会手外科学会上肢部分功能评定试用标准评定：优20指，良7指。差3指，优良率90％。结论按照手指旋转撕脱性离断伤不同情况采用不同再植方法，可获得较高的成活率，并能恢复较好的外形与功能。

Objective To investigate the replantation methods and treatment outcome of severed fingers with rotated and avusled injury. Methods 21 cases （30 fingers） with rotated and avusled injury were replanted. According to the different injuries of severed fingers, blood vessel replantation,transposition of neurovascular blundle, vasular pedicle skin flap transfer were applied to reconstruct the circulation and sensation. Results 29 severed fingers survived and 1 failed, the survival rate was 96.7%. 21 cases were followed up 6 months to 3 years with an average of 1years and 5 months. At the last follow-up, the results were graded as good in 20 cases,fair in 7 cases and poor in 1 cases according to the upper limb function evaluation criteria issued by The Hand Surgery Society of The Chinese Medicel Association. Conclusion According to the different section,applying different methods to replant the severed fingers could increase the survival rate, the apperance and function recovered satisfactorily.