创伤性自体小关节移植在临床中的应用

目的：我院成功进行创伤自体小关节移植手术，拟文探讨手（足）小关节组织缺损情况下的创伤性自体小关节移植的长期临床效果。方法：对我院于2004年5月-2013年5月收治的24例急性手外伤多指损伤合并关节损伤缺损患者行创伤自体小关节移植手术，方法：常规手外伤清创后，采取开放性手术治疗，移植修补缺损关节面，采用克氏针固定法对小关节移植区进行固定。回顾性总结分析24例患者临床资料及远期疗效。结果：24例患者病例跟踪调查6个月以上，其中采用创伤性白体小关节移植患者（观察组）治愈10例，明显好转10例，好转3例，无效1例。总治疗有效率为95．8％，术后观察无死亡或并发症。并且与传统带血管蒂游离移植手术治疗的患者（对照组）对比，在存活率、性别、年龄等无明显统计学差异的情况下，恢复优良率较高且简单易行。结论：创伤自体小关节移植手术应用于急性手外伤多指损伤合并关节损伤缺损患者能够在足部供区的组织代价也相对较轻的情况下，取得满意的手部小关节修复，因此可以为患者所接受。

Traumatic Facet Autoiogous Transplantation in Clinical Application

Objective.. Our hospital successful small joint trauma autologous transplants, the proposed paper discusses the hand （foot） facet joint tissue defects in case of traumatic facet autologous transplant long-term clinical results. Methods in our hospital in May 2004 to May 2013 were treated 24 cases of acute hand injuries multi-finger injury combined with joint damage defect underwent trauma autologous small joints transplant. Methods.. Conventional hand injury after debridemcnt,take open surgery therapy, transplant repair articular surface defects, using Kirschner wire fixation for small joint transplantation area fixed. Retrospective analysis of 24 patients, clinical data and long-term efficacy. Resalts. 24 cases of patients with follow-up survey six months or more, which uses small joints traumatic autologous transplant patients（observation group） 10 cases were cured, 10 cases markedly improved, improved in 3 cases, 1 case. The total effective rate was 95. 8%, with no deaths or postoperative complications. And with the traditional vascularized graft surgery patients （control group） compared the survival rate, gender, age, etc. was no significant difference in the case, good rate of recovery is high and easy. Conclusion：Trauma autologous transplants used in the small joints of acute traumatic hand injury combined with multi-finger joint damage in patients with defects in the foot for the area can be organized relatively minor consideration in the case, to achieve a satisfactory repair small joints of the hand, it can be for patients to accept.