幼儿前臂及腕掌部毁损伤寄养再植一例

Ectopic replantation of forearm,wrist and palm in a destructive injury of a young child:A case report

本文报道2017年6月郑州仁济医院外科一区收治1例左前臂及腕掌部毁损伤、第3~5指离断伤幼儿。手术一期行前臂及腕掌部血管、神经、肌腱修复加腹部皮瓣修复术加第3~5指寄养再植术;二期行腹部皮瓣断蒂;三期行寄养手指回植及游离股前外侧皮瓣(ALTF)修复足部供区;四期行手指功能重建及足部皮瓣显微削薄术。术后4年随访,第3~5指与拇指可完成抓捏、对掌功能,轻度活动受限,足部皮瓣无明显臃肿,感觉恢复至S3,走路、跑步不受影响。

Reports a case admitted in the Ward I of Department of Surgery of Zhengzhou Renji Hospital in June 2017.A young child who suffered destructive injury of left forearm,wrist and palm with severed 3rd-5th fingers.Tendon and neurovascular repairs of forearm,wrist and palm were performed with pedicled abdomina flap and the 3rd-5th fingers ectopic replantation in Phase I surgery.In the Phase II surgery,the abdomina flap division was carried out.The replantation of severed fingers after ectopic replantation and the reconstruction of foot defect with free anterolateral thigh flap(ALTF)were carried out in Phase III surgery.In Phase IV surgery,fingers functional reconstruction and foot flap thinning were performed.Four years after surgery,the thumb oppositions to middle,ring and little fingers could be completed,with slightly limitations.The appearance and texture of transferred foot flap were good,and the child could walk and run almost normally.