渔船网绳绞伤致拇指旋转撕脱伤9例

9-cases report of rotated and avulsed thumbs injured by the towrope

目的 改进拇指旋转撕脱性离断再植方法 ,提高再植速度 ,缩短离体指体的缺血时间。方法 通过对 9例拇指旋转撕脱性离断的临床显微解剖 ,将拇指主要动脉损伤分成轻、中、重三度 ,采用先修复动脉的修复方法。根据指神经撕脱伤的特点及第 1指掌侧总神经的解剖特点直接修复两侧指神经。改变肌腱的缝合部位 ,减少肌腱的粘连。结果 临床应用 9例全部成活。经 6～ 12个月随访 ,再植手指均获得满意的外形和功能。结论 拇指旋转撕脱性断指再植的改进方法实用、简单、快速、成活率高。

Objective To improve the replantation method of severed thumb with rotated and avulsed injury,speed up the replantation and shorten the ischemia time of the severed thumb.Methods 9 cases of severed thumb with rotated and avulsed injury were investigated by the method of microanatomy,and injuries of thumb primary artery were divided into three degrees:mild,moderate and severe.Arteries were repaired first.According to the properties of digital nerve avulsed injury and the common palmar digital nerve,we repaired bilateral digital nerves directly,and altered the tendon suturing position to reduce the adhesion of tendons.Results All the total 9 cases survived,and after 6~12 month follow-up,the appearance and functions were satisfactory.Conclusions A simple,practical,and quick operation method with high survival rate for rotated and avulsed thumb was obtained.