保留关节的小儿指间关节离断再植

Replantation of the interphalangeal joint with reserving joint in children

目的探讨非断面截骨保留关节的小儿指间关节水平离断再植的方法和疗效。方法自2008年1月至2016年1月，对19例指间关节水平完全离断的小儿断指，采用近端指骨中远1/3平面截骨短缩0．3～0．5cm不等，保留损伤的指间关节进行再植。结果再植指全部存活，随访时间为6～36个月，平均17个月，根据中华医学会手外科学会上肢部分功能评定试用标准进行疗效评定：优14例，良4例，差1例。再植指体发育良好，指间关节活动好，x线片显示关节面完整，退变不明显。结论对于指间关节水平的小儿断指，通过近端指骨的截骨短缩进行再植，保留关节和骨骺，恢复关节的灵活性及指体的正常发育。

Objective To discuss thetreatment method and clinical efficacy of replantation of the interphalangeal joint with non-section osteotomy and reserving joint in children. Methods From January 2008 to January 2016, 19 children with completely severed interphalangeal joint were treated with distal middle 1/3 plane osteotomy shortening 0.3 to 0.5 cm, and the injured interphalangeal joints were reserved and replanted. Results All the replanted fingers survived uneventfully. The follow-up time ranged from 6 to 36 months with an average of 17 months. According to the upper extremity function evaluation criteria issued by Hand Surgery Society of the Chinese Medical Association, the results were graded as excellent in 14 cases, good in 4 cases and poor in 1 case. The replanted fingers were well developed with good interphalangeal joint motion. X-ray showed that the articular surface was intact without obvious degeneration. Conclusion For the children with completely severed interphalangeal joint, the replantation of interphalangeal joint with osteotomy and shortening of the proximal phalanx can reserve joint and epiphysis. The joint flexibility is restored and the normal development of the injured finger is observed.