挤压旋转撕脱性断指再植手术方法与疗效观察

目的探讨挤压旋转撕脱性断指再植不同手术方法的临床效果。方法1993年5月～2003年1月，对挤压旋转撕脱性手指完全离断实施再植术76例84指，其中应用自体小静脉移植19例27指，采用掌、指固有动脉全段移位13例13指，行邻指指固有动脉远端血管局部转位44例44指。结果自体小静脉移植组成活11例16指；采用掌、指固有动脉全段移位再植成活12例12指，1例部分成活；而进行邻指指固有动脉远端血管局部转位的44例44指全部成活。所有成活病例术后随访6个月-5年，按断指再植功能标准评定，三种手术方法优良率分别为68．7％、83．3％、95．5％。结论挤压旋转撕脱性手指完全离断，应用邻指指固有动脉远端血管局部转住治疗效果良好，是一种实用有效的再植方法。

Operational methods and observation of replantation of severed fingers with crushed and rotation avulsion

Objective To explore the treatment outcome of different operational methods of severed fingers with crushed and rotation avulsion.Methods From May 1993 to Jun 2003,76 cases(84 fingers) of severed fingers with crushed and rotation avulsion were replanted,19 cases(27 fingers)by their own small veins,13 cases(13 fingers) by transferring palmar or digital proper arteries,44 cases(44 fingers) by transferring neighbouring digital proper arteries. Results Eleven cases(16 fingers)survived with replantation by their own small veins,12 cases(12 fingers)survived and 1 cases(1 finger)partly survived with replantation by palmar or digital proper arteries,otherwise,all of the 44 cases(44 fingers) survived with replantation by transferring neighbouring digital proper arteries. After operation,the following-up for all of the survival fingers ranged from 6 months to 5 years.According to the functional evaluation standard,the excellent rate in 3 operational methods were 68.7%,83.3%,95.5%.Conclusion It can obtained good treatment outcome that using replantation by transferring neighbouring digital proper arteries for severed fingers with crushed and rotation avulsion.