仅吻合双侧指掌侧固有动脉甲根离断断指再植10例

10 cases of replantation of severed fingers at fingernail root only by anastomosing bilateral proper palmar digital artery

目的探讨末节甲根部平面以远的离断指应用无需吻合静脉回流的再植方法及疗效。方法2019-2022年对10例于末节甲根部平面离断的手指,仅作双侧指掌侧固有动脉吻合而不需吻合静脉的再植修复。结果10例甲根部平面离断手指再植后,全部成活,再植成活率为100%。出院后10例均得到随访,随访时间3~6个月,再植后成活指体的功能与外观恢复良好,患者对手术结果满意。结论手指甲根部及以远的指体离断,基本无静脉可吻合。在再植时只吻合双侧指掌侧固有动脉而不吻合静脉的情况下,早期血流及供血通过双侧指掌侧固有动脉达到供血压力平衡、不会导致供血过多,而后重建动静脉网达到正常静脉血液回流,使其成活,术后断指成活情况较好,此方法可于临床推广应用。

Objective To investigate the replantation method and effect for the severed fingers far from the fingernail root without any anastomotic verous teturn.Methods Ten cases of severed fingers far away from the fingernail root were admitted from 2019 to 2022,the severed fingers were replanted only by anastomosing bilateral proper plamar digital artery without any anastomotic verous return.Results All 10 replanted fingers survived,the survival rate of replantation was 100%.All 10 cases were followed up for 3 to 6 months,the function and appearance of the survival finger recovered well,and the patients were satisfaction with the effect.Conclusion The severed fingers far from the nail root have almost no veins to anastomose.Under the condition of only anastomosing bilateral proper palmar digital artery without any venous anastomosis.Early bolld flow and supply are achieved through bilateral proper palmar arteries to achieve blood supply pressure balance,without causing insufficient blood supply.Then,the arterial and venous network is reconstructed to achieve normal venous return,allowing it to survive.The postoperative survival is good and can be promoted.