双平面Kessler肌腱缝合法结合手指屈伸角度交替变换固定在前臂离断再植中的应用

The application of biplane Kessler tendon suture combined with alternating finger flexion-extension angle fixation in the replantation of amputated forearm

目的 探讨双平面Kessler肌腱缝合法结合手指屈伸角度交替变换固定在前臂离断再植中的应用效果。方法 采用双平面Kessler肌腱缝合法结合手指屈伸角度交替变换固定行断肢再植治疗15例前臂离断伤患者。结果 14例断肢再植成活,1例因挫伤严重坏死截肢。14例再植成活者术后随访16~60个月,手的外形和屈伸活动满意。末次随访时,参照中华医学会手外科学会上肢部分功能评定试用标准评价疗效:优5例,良6例,可2例,差1例,优良率11/14。结论 采用双平面Kessler肌腱缝合法结合手指屈伸角度交替变换固定治疗前臂离断伤,操作简单,肌腱粘连程度轻,患者能够早期康复训炼,功能恢复良好。

Objective To investigate the effect of biplane Kessler tendon suture combined with alternating finger flexion-extension angle fixation in the amputated forearm replantation.Methods The 15 patients with forearm amputation injuries were treated with biplane Kessler tendon suture combined with alternating finger flexion-extension angle fixation.Results Replantation of amputated limb survived in 14 cases,1 case failed due to severe necrotic amputation. The 14 cases of replantation survivors were followed up for 16 ~ 60 months after operation,who had satisfactory appearance and good recovery of flexion-extension activities. At the last follow-up,the effect was assessed with the functional evaluation trial standards of upper limbs of Hand Surgery Society of Chinese Medical Association,the results was excellent in 5 cases, good in 6 cases,fair 2 cases and poor in 1,with the excellent-good rate of 11/14.Conclusions Biplane Kessler tendon suture combined with alternating finger flexion-extension angle fixation can be used to treat forearm amputation injury,with simple operation,which can reduce tendon adhesion,lead to early rehabilitation training and good functional recovery.