手部压砸伤的急诊处理及功能恢复

Emergency treatment and functional recovery of the crush injury of hand

目的 探讨急诊处理手部压砸伤的方法和疗效。方法 对 132例患者 ,用无创技术彻底清创、骨折内固定后修复断伤的各种组织 ,用游离皮瓣、岛状皮瓣或带蒂皮瓣修复手部软组织的缺损。伤口愈合后辅以理疗及活血化瘀的中药泡手 ,术后尽早进行康复训练。结果 90例在术后随访 2～ 18个月 ,42例失访。按肌腱评定标准 (TAM )评定 ,手功能恢复优 2 8例 ,良 30例 ,中 2 1例 ,差 11例 :优良率为64.4%。结论 急诊手部压砸伤的正确处理。

Objective To investigate the methods and treatment outcome of emergency treatment of crush injury of hand. Methods One hundred and thirty-two cases of soft tissue defect of hand were involved. After radical debridement and internal fixation of fracture using non-traumatic technique, free flaps, island or pedicle flaps were done. Following wound healing, physical therapy and dipping hand in Chinese traditional medicine, which can promote blood circulation and removing blood stasis, were carried out at the early stage. Rehabilitation was carried out after operation as early as possible.Results Ninety cases were followed up over a period of 2 to 18 months after operation. There was loss of follow-up in 42 cases. According to the tendon evaluation criterion, the result was excellent in 28 cases, good in 30 cases, fair in 21 cases and poor in 11 cases. The overall excellent and good rate was 64.4%. Conclusions Emergency treatment of crush injury of hand, wound coverage and postoperative early rehabilitation is important for the results of hand function.