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探究显微镜下末节断指再植手术治疗手指末节断指患者的效果。方法 选取2022年1月-2023年
8月遵义市播州区人民医院收治的42例手指末节断指患者纳入研究,按照手术方法不同分为观察组(21例)
和对照组(21例)。观察组实施显微镜下末节断指再植手术,对照组实施常规断指再植手术,比较两
组治疗效果、断指修复指标及断指功能。结果 观察组治疗总有效率为95.24%,高于对照组的80.25%
(P<0.05);观察组DIPJ大于对照组,断指指甲长度长于对照组,两点辨别觉短于对照组,且并发症发生
率低于对照组(P <0.05);观察组各维度断指功能评分高于对照组(P <0.05)。结论 予以手指末节断指
患者显微镜下末节断指再植手术治疗效果理想,可促进断指修复,提升断指功能。 相似文献
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从1998年10月~2002年7月,我院对29例疑难末节断指进行了再植,获得良好疗效。1资料与方法1.1一般资料本组29例,男18例,女8例,其中学龄前小儿3例。静脉缺损15例(近端5例,远端10例),动脉缺损14例(近端4例,远端10例),所有病例均能找到一侧或两侧指神经。1.2处理方法1.2.1远端缺静脉近端有静脉者,吻接一侧动脉,供血通畅后,另一侧动脉与近端静脉吻接,共10例,全部成活。1.2.2近端缺静脉者,吻接一侧动脉或二侧动脉后分别行断端疏松缝合2针,使断面渗血2例;指尖侧切口渗血3例。共成活4例,失败1例。1.2.3近端缺动脉者,… 相似文献
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吻合指动脉的末节断指再植27例 总被引:3,自引:0,他引:3
手指中节或拇指近节指骨 1/ 3以远处离断再植为末节断指再植术。由于末节断指的血管较细小 ,吻合困难 ,需精细的吻合技术 ,其静脉不易吻合成功。我们自 1997年~ 2 0 0 2年 ,对末节断指吻合指动脉再植 2 7例 ,取得较好效果 ,报告如下。1 临床资料本组男 18例 ,女 9例。年龄 2 1~ 4 3岁。伤后 30分钟~ 4小时急诊入院。其中拇指 8例 ,食指 12例 ,中指 5例 ,无名指 2例。电锯伤 13例 ,利器切割伤 14例 ,无合并其他部位损伤。手术在显微镜下常规行断指远、近端创面清创 ,将两侧指动脉修整显露 ;用 3/ 0丝线行双“8”字缝合肌腱 ,0 .8mm克氏针… 相似文献
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末节断指再植与分型 总被引:3,自引:0,他引:3
目的探讨末节手指断指再植术与分型方法.方法对末节断指再植67例86指进行前瞻性研究,依断指平面、损伤类型,分为五区、三级,即Ⅰ区中节指骨远1/3至远指间关节囊近侧缘;Ⅱ区远指间关节平面(关节囊内);Ⅲ区远指间关节囊远侧至甲后襞游离缘;Ⅳ区后甲襞游离缘至甲1/2;Ⅴ区甲1/2以远.A级指体无挫伤,断面整齐;B级指体明显挫伤,断面不整齐、缺损,但可以靠短缩指骨克服血管缺损;C级指体严重挫伤或撕脱伤,软组织缺损需要组织移植或移位.最终以"区-级"组合成15型.结果本组涉及10型,总成活率95.3%.成活率与分区无关,而A级>B级>C级.功能受分区和分级的共同影响,总体Ⅳ、Ⅴ区功能最好.结论此分类方法,有利于在具有可比性下统计成活率,衡量断指再植水平、指导治疗及评估预后. 相似文献
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单纯吻合指动脉的末节断指再植 总被引:9,自引:3,他引:6
目的:探讨采用单纯吻合指动脉的末节断指再植的疗效。方法:回顾分析单纯吻合指动脉的末节断指再植21例23指,其中端端吻合16指,交叉吻合3指,动脉移植吻合4指,术后予肝素湿敷及放血。结果:23指成活21指,失败2指。成活率为91.3%。结论:单纯吻合指动脉的末节断指再植,手术费时短。要使手术成功,其关键因素除小血管吻合技术外,术后放血亦同等重要。 相似文献
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目的 探讨不同平面末节断指的再植方法.方法 2004-2007年,对63例71指末节断指,按损伤部位分为4区,采用静脉移植和吻合掌侧静脉的方法进行再植.结果 术后71指存活70指.随访时间为3个月至3年,再植手指饱满,手指长度正常,指甲外观满意.再植指两点分辨觉平均为6.5 mm,除Ⅳ区关节融合者外,其余拇指指间关节与远侧指问关节活动度平均为69°.结论 对末节断指的处理,为保留手指长度和指甲,血管移植修复是必要的,尤其是Ⅱ区和Ⅲ区,同时行掌侧静脉吻合对末节再植的成功至关重要. 相似文献
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目的探讨采用携带开放侧支的静脉移植进行末节(Ⅱ~Ⅳ区)断指再植的方法和疗效。方法2008年6月-2009年12月,对20例20指末节断指,采用携带1-3个(平均2个)开放侧支的静脉移植修复动脉进行再植,静脉干的侧支无需结扎,保留动脉吻合口近端的侧支1-3个(平均1.5个)。结果20例20指全部成活,术后6个月-1年(平均8个月)随访17例,参照TAM系统评定:优14例,良2例,可1例,优良率94%。结论携带开放侧支的静脉移植进行末节断指再植是一种行之有效的方法。 相似文献
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Flexor digitorum profundus (FDP) tendon avulsion is a common injury in sports. This is secondary to forced extension against flexor digitorum profundus contraction. However, avulsion injury of the FDP tendon secondary to an enchondroma of the distal phalanx is extremely rare. There have only been three previous reports of such an occurrence. This report describes a fourth case of an avulsion injury of the FDP tendon secondary to enchondroma of the distal phalanx of the fourth digit. 相似文献
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Background
Headless compression screws have been used for arthrodesis of the distal interphalangeal joint with good clinical results. However, some distal phalanges are too small, thus precluding their use, or increasing complication rates.Methods
In order to validate our digital measurements, radiographs of five cadaveric hands were obtained. The distal phalanges of these fingers were measured using our institution’s digital radiograph software. The cadavers were then dissected, and the actual phalanges were measured to confirm the accuracy of the digital measurements; 200 consecutive hand radiographs were then measured to obtain average width and heights of the narrowest measurements of the distal phalanx of each finger. Subgroup analysis of each finger for age and gender was completed.Results and Conclusions
Females were routinely smaller than their male counterparts. No age-related differences were seen. A substantial number of fingers were found to be too small to allow for use of headless compression screws; 42 % of small finger distal phalanges are too small to accommodate 2.8-mm threads, and that number increases to 81 % with 3.2-mm threads and 97 % with 3.5-mm threads. Few distal phalanges, regardless of which finger, are large enough to accommodate 3.5-mm-diameter threads; 22% of female ring finger distal phalanges are smaller than 2.8 mm, and 66 % of ring fingers are smaller than 3.2 mm. Based on our measurements, a surprising number of distal phalanges are smaller than the trailing thread diameter of commonly commercially available headless screws. Care must be taken in selecting implants for distal interphalangeal (DIP) fusion. 相似文献17.
The exposed nature of the peripheral portion of the fingers make fractures of the distal phalanges the most commonof workplace injuries. Most are simply treated by local wound care and protective splinting, both for comfort and to prevent further injury. Articular injuries, however, are more complex and require recognition by the primary examiner so that appropriate treatment can be applied. 相似文献
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末节指神经血管显微解剖及临床意义 总被引:6,自引:1,他引:5
目的为手指末节外伤的修复特别是感觉的恢复提供解剖学依据。方法在12只经动脉灌注红色乳胶的成人新鲜手标本上,手术显微镜下观察、测量手指末节区域内神经与血管的走行、分支、分布、外径及二者的形态学关系。结果指掌侧固有神经多在末节指动脉弓起始处跨过指动脉行向指腹及侧背部,主干分两支,其内外支起始处横径分别为0.7~0.9mm、0.7~0.8mm,在半月线平面的横径分别为0.6~0.8mm、0.5~0.7mm,左右分支间相互交叉分布,其分支比伴行的动脉低且稍粗。结论指神经多在末节指骨底分支到指腹、指尖和指背,末节断指再植神经、血管吻合的适宜解剖区为远侧指间关节至指甲中1/3区。 相似文献
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目的探讨应用动静脉转流的方法再植手指末节脱套性断指的可行性和临床效果。方法对12例12指脱套性断指采用逆行再植顺序,应用动静脉转流的方法重建血液循环。结果12例再植11例成活,术后随访6~14个月,手指感觉和运动功能恢复良好。结论对于找不到可供吻合静脉的末节脱套伤断指,应用动静脉转流的方法再植是可行的。 相似文献