拇指近节撕脱性脱套完全离断再植的临床疗效

The clinical effect of replantation on the complete degloved thumb amputation at the level of proximal segment

目的探讨拇指近节撕脱性脱套完全离断再植手术的临床疗效。方法 2013年2月-2016年12月,对63例拇指近节撕脱性脱套完全离断患者的治疗进行回顾性分析。术后随访观察手指外观、指端感觉、手部功能恢复情况。结果术后成活60例,按照中华医学会手外科学会上肢部分断指再植功能评定试用标准评定疗效,优54例,良2例,可4例,优良率93.3%。结论拇指近节撕脱性脱套完全离断伤进行再植,成活后外观和功能良好。只要患者全身情况允许,远端离断指体尚完整,有可供吻接的血管和神经,并注意操作细节,即可将再植的绝对禁忌证转为相对禁忌证,并有较高的成活率。

Objective To discuss the clinical effect of the replantation on the complete degloved thumb amputation at the level of proximal segment. Methods From February 2013 to December 2016, we retrospectively analyzed the treatment of 63 cases with complete degloved amputation in the proximal segment of the thumb. The appearance of fingertip sensation and function recovery condition observed after surgery. Results Sixty cases survived, according to the evaluation criteria of the evaluation were standard of the upper extremity of standard the upper limb of the Chinese medical association, excellent in 54 cases, good in 2 cases, fair in 4 cases with the excellent and good rate of 93.3%. Conclusion As to the complete degloved thumb amputation at the level of proximal segment, the appearance and function after replantation is good, as long as the patients＂ general condition allows, the distal amputated thumb is complete, there are available blood vessels and nerves, pay attention to operation details, the absolute contraindications can be change to relative contraindications, and has a higher snrvival taro