断指再植与非断指再植对手指末节完全离断的疗效比较

Comparison of therapeutic effect of the replantation and non-replantation on the amputated distal finger

目的:比较断指再植与非断指再植在手指末节完全离断伤治疗中的疗效。方法:286例行手指末节完全离断手术患者中,观察组112例(118指)行断指再植术,对照组174例(183指)行非断指再植术(包括皮瓣修复、原位缝合以及残端修整)。比较2组患者的指体美观、指甲长度、两点辨别觉、远端指间关节活动度以及手指感觉。结果:观察组成活率为97.46%,对照组为94.54%,2组差异无统计学意义(P>0.05)。术后6个月观察组指甲长度、两点辨别觉、远端指间关节活动度及手指感觉均明显优于对照组(P<0.01);观察组手指各关节活动度优良率为97.39%,高于对照组的77.86%(P<0.05)。结论:严格遵循不同术式的适应证和技术要求,是取得临床治疗成功的关键。

Objective： To compare the therapeutic effect of the replantation and non-replantation of amputated finger on the amputated finger in the distal finger. Methods： Among the 286 patients treated with distal finger complete disconnection operation,the 118 fingers（ 112 cases） in observation group were treated with replantation,the 183 fingers（ 174 cases） in control group were treated with nonreplantation（ including skin flap repair,suture in situ and stump dressing）. The figure appearance,nail length,two-point discrimination,distal interphalangeal joint motion and finger sense between two groups were compared. Results： The survival rate in the observation group the and control group were 97. 46% and 94. 54%,respectively,the difference of which was not statistically significant（ P〈0. 05）. The nail length,two-point discrimination,DIPJ activity and finger sense in the observation group were better than those in the control group after 6 months of operation（ P〈0. 01）. The excellent rates of finger joints activity in the observation group and the control group were 97. 39% and 77. 86%,respectively,the difference of which was statistically significant（ P〈0. 05）. Conclusions： Strictly following the indications of different operations and technical requirements are the key of the success of the clinical treatment.