异体手移植骨骼支架构建的临床应用

目的总结并探讨异体手移植骨骼支架重建的临床经验及意义。方法2001年1月～2003年10月，对4例6手前臂不同平面离断及手缺失的患者行异体手移植，据术前计划及术中具体情况，按照AO内固定原则将受体尺、桡骨分别于小同水平与供体尺、桡骨解剖复位，3．5mmAO钢板、螺丝钉内固定。定期摄X线片并观察移植手功能恢复情况，并加以评价。结果术后随访4～36个月，本组4例6手尺、桡骨平均于术后9周达到临床愈合。从关节活动度、肌力、感觉恢复、外肜、后遗症状及工作能力6方面综合评价，6只移植手临床功能恢复满意。结论牢固而确实的骨骼支架重建对异体移植手功能恢复意义重大。

CLINICAL APPLICATION OF SKELETON RECONSTRUCTION IN HUMAN HAND ALLOGRAFT

Objective To study and summarize the clinical experience and significance of the skeleton reconstruction of human hand allografts. Methods From January 2001 to October 2003, human hand allografts were applied to treat 4 cases of traumatic hand defect(6 hands) at different levels. During operation, the ulna and radius were reduced anatomically and fixed firmly with 3-5 mm AO-plates and screws according to AO internal fixation principle. The X-ray films were taken periodically and the function recovery of hand allografts was observed and estimated. Results The 4 cases were followed up for 4-36 months postoperatively. The clinical healing of fracture in 4 cases(6 hands) was achieved after 9 weeks, and by means of comprehensive assessment including the joint function, muscle strength, sensation, appearance, sequela and the ability of work, the satisfactory effects were gained eventually. Conclusion It is significant for human hand allografts to reconstruct skeleton firmly.