急诊利用废弃指再植前臂再造手指

Replantation of forearm with abandoned fingers for emergency finger reconstruction

目的探讨急诊利用废弃指再植前臂再造手指的手术方法及临床疗效。方法自2003年2月至2019年2月,我们对15例手腕部毁损伤仅存有2指或3指尚完整的患者,急诊取废弃手指再植前臂再造手指,其中再造3指2例、再造2指13例。结果术后所有再造手指均存活,创口均I期愈合。术后随访时间为3~12个月,平均6个月,再造手指外形接近原手指,功能良好,具备抓握等基本功能,指腹感觉恢复良好,两点分辨觉为5-10mm,患者比较满意。按中华医学会手外科学会拇、手指再造功能评定试用标准评价疗效:优3例,良9例,差3例。结论急诊利用废弃指再植前臂再造手指,术后疗效满意,是一种急诊治疗手腕部毁损伤,重建和恢复部分手功能的较为理想的方法。

Objective To explore the surgical method and clinical efficacy of emergency finger reconstruction with forearm replantation using abandoned fingers.Methods From February 2003 to February 2019,15 patients with only 2 or 3 finger intact were treated by forearm replantation using abandoned fingers for finger reconstruction.Among them,3 fingers were reconstructed in 2 cases and 2 fingers were reconstructed in 13 cases.Results All reconstructed fingers survived and the wounds achieved primary healing.The follow-up time was 3 to 12 months with an average of 6 months.The reconstructed finger was similar to the original finger in shape,with good function,grasping and other basic functions.The pulp sensation recovered well.The two-point discrimination was 5 to 10 mm.The patients were satisfied.According to the evaluation criteria of thumb and finger reconstruction function issued by the Hand Surgery Society of the Chinese Medical Association,the results were rated as excellent in 3 cases,good in 9 cases and fair in 3 cases.Conclusion Emergency replantation of forearm with abandoned fingers to reconstruct finger is an ideal method for emergency treatment of wrist injury,reconstruction and recovery of some hand functions.