56例拇指旋转撕脱离断再植回顾性分析

Retrospectively analyse and discuss of replantation of rotational avulsed thumb in 56 cases

目的回顾性分析和探讨拇指旋转撕脱离断的再植方法和疗效。方法2011年3月-2016年4月对56例拇指旋转撕脱离断伤分别采用直接吻合、动脉转位、动脉交叉吻合、浅静脉移植、静脉动脉化修复动脉，采用静脉直接吻合、浅静脉移植、示指背静脉瓣转位修复静脉进行再植。结果术后56例成活54例，坏死2例。成活的54例随访3～12个月，平均9个月。根据中华医学会手外科学会断指再植功能评定试用标准评定：优29例，良23例，差2例。结论根据拇指旋转撕脱离断伤不同伤情选择不同的再植方法重建患指血供，可减少再植指坏死率，使再植指获得良好的外观、功能。

Objective To retrospectively analyse and discuss the method and curative effect of replantation of rotational avulsed thumb. Methods From March 2011 to April 2016, In the hand surgery department of our hospital, we replanted rotational avulsed thumb by anastomosing artery directly, artery translocation, crosswise anastomosing artery, replanting superficial vein, arterializing vein to repair artery, by anastomosing vein directly, transplanting superficial vein, venous flap of the dorsal part of index finger translocation. Results Of all 56 cases in this group, 54 cases survived, necrosis occured in 2 cases. Follow-up of 54 survival cases for 3~12 months, 9 months averagely. Evaluated according to the replantation of severed finger function evaluation standard of Hand Surgery Association of Chinese Medical Association： excellent in 29 cases, good in 23 cases, poor in 2 cases. Conclusion According to different conditions of rotational avulsed thumb choosing different method to reestablish blood supply, can reduce replantation necrosis rate and obtain a replanted finger of good appearance and function.