多手指多节段离断再植

目的探讨多手指、多节段断指再植的方法及功能恢复。方法对12例43指113节段予以再植,采用分组协作、“流水式”清创、“逆行法”再植的方法,按先远端、后近端顺序依次再植示、中、环、小指。结果再植指成活率93.0%,平均随访3.5年,手功能评定:优2例,良5例,差4例,劣1例,优良率58.3%。结论多手指、多节段断指再植采用非常规方法,仍能获得较高成活率;手功能恢复较差原因可能有适应证选择、贯穿关节固定、忽视术后康复等有关。

Replantation of multiple digits and multiple segments

Objective To explore methods of replantation and hand function rehabilitation of multiple digit and segment amputation. Methods 12 cases with 43 fingers (113 segments) of multiple digit and multiple segments amputation were replanted and reviewed. The operations were carried out by group co operation, flow process debriding, and reversal replantation. The order of multiple digit replantation was index finger, middle finger, ring finger, and little finger. The sequence of multiple segmental digit replantation was distant severed side first, then approximate side, and last more approximate side. Results The surviving rate of replantation was 93.0%. The average follow up was 3.5 years. Of 12 cases , 2 obtained excellent results, 5 good, 4 fair, and 1 bad. The successful rate of hand function was found to be 58.3%. Conclusion Higher surviving rate of replantation can be got with non routine methods in multiple digit and segments injury. Factors that probably lead to bad hand function recovery may be poor clinical indications, multiple finger joint fixation and ignoring digit rehabilitation after operation.