甲根以远末节断指改良分型和再植方法的疗效分析

目的探讨甲根部以远末节断指改良分型和再植方法与成活率的关系。方法对30例39指末节断指，按改良分型，采取吻合指动脉＋指腹静脉＋神经，吻合指动脉＋神经＋指尖小切口放血或拔甲后少量肝素注射，断指组织短缩并去除（部分）指骨原位缝合，再植后腹部皮下包埋的方法，进行再植。结果再植后成活33指，坏死5指，部分坏死1指，总成活率85．9％。结论甲根部以远末节断指，按改良分型选择再植方法，能提高成活率；原位缝合时注意打结力量，使线结内近端正常组织保持红润。

Effects analysis of replantation of distal segment finger amputation beyond nail root by modified types and different kinds of operation

Objective To discuss the effects of the distal segment finger amputation beyond nail root replantation by the modified types and different kinds of operation.Methods 30 cases with 39 severed fingers were undergone distal segment replantation,according to the modified types and by the below methods： anastomosed the digital artery＋vein in palm side＋nerve、anastomosed the digital artery＋nerve＋blood letting through short incision in digital tip or removed the finger nail with the little dose heparin injection, original location suture after shorten the tissue of the severed fingers distal segment and removed its （partial）bone,covered into the abdominal subcutaneous.Results 33 survived, 5 necrosis, 1 partial necrosis. The survival rate was 85.9%.Conclusion According to the modified types and proper kinds of replanting operation, the replantation survival rate of the distal segment finger amputation beyond nail root can be improved.During original location suture, the strength of the suture knoting must let the proximal normal tissue in the knot maintain ruddy.