绞扎性上肢损伤的修复与一期功能重建

目的 探讨上肢绞扎性损伤的修复与一期功能重建的方法及临床效果.方法 对6例上肢绞扎伤采用前臂切开减压,一期修复血管、神经、肌腱和肌腱移位功能重建术.结果 术后6例上肢全部存活,随访时间1～6年,平均18个月,患肢外形和功能满意.按中华医学会手外科学会上肢部分功能评定试用标准评定:优3例,良2例,差1例;优良率83.3％.结论 绞扎性上肢损伤为多种组织复合伤,伤情复杂,严格掌握手术适应证,采用显微外科修复技术,一期重建肌腱功能可获得较好的效果.

Repair and primary functional reconstruction of upper limb strange injuries

Objective To explore the method and clinical results of the repair and primary functional reconstruction in upper limb strangle injuries.Methods Six cases of upper limb strangle injuries were treated by forearm incision decompression and primary repair of the blood vessels,nerves,tendons and functional reconstruction with tendon transfer at the same time.Results All of the 6 upper limbs survived.Postoperative follow-up ranged from 1 to 6 years,with an average of 18 months.The appearance and function of the upper limbs were satisfactory.According to the upper limb functional assessment criteria issued by the Hand Surgery Society of the Chinese Medical Association,the results were graded as good in 3 cases,fair in 2 cases and poor in 1 case,with a satisfactory rate of 83.3％.Conclusion Upper limb injuries are complex injuries that involve multiple tissue lesions.When proper surgical indications are strictly followed,primary tendon reconstruction using microsurgical techniques can achieve significant effects.