树枝状静脉移植在手部创伤中的应用

目的探讨手掌严重碾挫伤应用血管移植手术方法的选择。方法对12例手掌碾挫伤伴血管损伤的患者，采用树枝状浅表静脉倒转后多级移植修复缺损的手掌动脉，同时对缺损皮肤一期行植皮或皮瓣修复。结果术后12例创面全部Ⅰ期愈合，手指血循环好。术后随访3～22个月，手功能评定： 优5例，良4例，可2例，差1例，优良率为75％。手掌恢复了良好的外形和功能，能完成手指的捏、握、对掌和对指功能。结论对严重的手掌毁损伤，利用树枝状静脉移植修复缺损的血管，能获得较好的手功能和外形。

Application of graded dendritic vein graft in the treatment of hand injuries

Objective To discuss the surgical strategy for selection of vessel grafts in the management of severe contusion injuries of the palm. Methods 12 cases of contusion injuries of the palm with polmar arch damage were involved in this study. Dendritic-shaped superficial veins were harvested, reversed and grafted to the arterial defect site in a mulfigrade fashion, Skin defect, if existed, was covered by skin graft or flaps. Results The follow-up period ranged from 3 to 22 months. All wound healed uneventfully. Blood circulation of the digits was good. Good recovery of appearance and function of the injured hand were obtained. Pinch and opposition was restored. Hand function was graded excellent in 5 cases, good in 4 cases, fair in 2 cases, and poor in 1 case. The overall excellent and good rate was 75%. Conclusion Dendritic-shaped superficial vein graft is a suitable way to repair palmar arch defect in contusion hand injuries.