拇指旋转撕脱性离断再植的临床研究

目的 探讨拇指旋转撕脱性离断再植的临床治疗方法及疗效.方法 对28例拇指旋转撕脱性离断患者,采用环指浅屈肌腱转位修复拇长屈肌腱,重建拇指屈曲功能,食指固有伸肌腱转位修复拇长伸肌腱,重建拇指伸指功能,环指桡侧指动脉、神经修复拇指指动脉、神经,食指指背静脉修复拇指静脉.结果 术后28例再植拇指全部成活.随访1～6年,再植拇指屈伸功能及外形恢复满意,两点辨别觉为5～9 mm.根据中华医学会手外科学会手功能评定试用标准,综合评价全部为优良.结论 此种转位方法对拇指旋转撕脱性离断再植,术后功能恢复满意,是一种安全有效的治疗方法.

Clinical study of replantation of rotational avulsion thumb

Objective To investigate the methods and the clinical results of replantation of rotational avulsion thumb.Methods Rotational avulsion thumb were replanted by transposition replantation in 28 patients superficial flexor tendon and radial artery/nerve of ring finger were transferred for repairing flexion function and artery/nerve of thumbs respective,intrinsic extensor tendon and dorsal vein of index finger were transferred for repairing extension function and thumb vein respectively.Results All the 28 thumbs survived.Follow-up ranged from 1 to 6 years.The outcome was satisfactory both functionally and cosmetically.2-PD was 5 to 9 mm.According to the criteria by Society of Hand Surgury of Chinese Medical Association,all replanted thumbs were ranked excellent.Conclusion Thansposition replantation of thumbs in this way is associated with satisfactory function recovery,and can be regarded as a safe and effective way for replantion of rotational avulsion thumb.