再植指晚期骨与关节畸形

目的　探讨断指再植后晚期骨与关节畸形的发生原因和矫治方法 ,并提出相应的预防措施。方法　 1990年 1月至 2 0 0 0年 5月 ,对 3 2 8个再植指进行长期随访 ,发现 85指晚期并发骨与关节畸形 ,对畸形发生的原因进行回顾性分析 ,并对其中 5 4指进行了各类修复和重建手术。结果　再植指晚期骨与关节畸形的发生原因包括 :内固定使用不当、骨与关节处理欠妥、肌腱粘连或修复不牢固、瘢痕挛缩、受伤机制的影响和小儿骨骺损伤等。 5 4指经功能重建术后 ,其功能评分较术前显著提高 (P <0 0 5 )。结论　断指再植后晚期并发骨与关节畸形的几率较高 ,在再植术中应用各种预防手段 ,可有效降低畸形的发生 ,从而提高再植指的功能。

Delayed deformity of bone and joint in replanted fingers

Objective To explore the causes,treatment and preventive measures of the deformity of bone and joint after replantation of fingers Methods From January 1990 to May 2000,85 fingers in a long-term follow-up of 328 replanted fingers were detected with deformity of bone and joint.Of them,54 deformed fingers were treated and reconstructed,the pathogenic mechanisms of deformity were retrospectively analyzed.Results The causes of deformity in bone and joint of replanted fingers included:incorrect internal fixation,improper disposal with bone and joint stump,adhesion of tendon,contraction of scar,influence of injury mechanism,epiphysis injury of children,etc.The Tamai's scores of 54 replanted fingers with secondary repairing operation were increased significantly (P<0.05).Conclusion The incidence of delayed bone and joint deformity in replanted fingers is higher.Various kinds preventive measures during replantation can prevent effectively deformity and improve function of fingers