手指多平面离断再植11例报告

Replantation of multi-level severed Digits in 11 patients

目的研究手指多平面离断再植的方法。方法首先将手指远断段“无血再植”,再将已接好的手指断段与近端再植,最后各段一起通血同时灌注。当手指部分节段毁损部分健康时,则切取足趾节段嵌入代替毁损的手指节段。结果本组11例24指成活23指,其中13指为两段离断,成活12指,2指为小指末节与中指中节毁损,分别取第二足趾末节与中节移植代替毁损的手指节段,均成活。结论手指多平面离断,通过节段再植与移植可取得较满意效果。

Objective To explore the replantation techniques for severed digits at multiple levels.Methods The distal parts of the severed digits were reattached to each other first by using exsanguine replantation,followed by reattachment of the distal two-in-one part to the proximal stump with simultaneous reperfusion of all severed parts.In the cases of devastating injury to some of the severed parts,a segment of the second toe may be used as an impacted transplant to replace severely disfigured segment of the finger.Results Of the24digits reattached in11patients,23digits survived.13digits were severed at2levels,of which12survived.2of another11multi-level amputations involved devastating injuries at distal phalanx of the little finger and intermediate phalanx of the middle finger,which were replaced with the distal and intermediate phalanges of the second toe,respectively,with all of them having survived.Conclusion Multi-level amputations of digits can be treated with the use of segmental reattachment or segmental transplantation techniques that in most cases lead to satisfactory results.