前臂及手严重毁损早期功能重建

介绍１９９２年１２月－１９９５年２月收治８例按传统概念需截肢的前臂及手部严重毁损伤施行的早期功能重建术。按毁损位及程度采用：（１）前臂毁损段修整，残掌残指异位中段再植；游离第２足趾带足背皮瓣、小腿外侧联合皮瓣再造拇指及修复创面；（２）残指异位再植，游离第２足趾带足背皮瓣再造拇、手指及修复创面；（３）断掌损无法再植，用游离第２足趾带足背皮瓣再造拇指于第１腕掌关节，皮瓣修复创面，并行第２掌骨示指化。随

Early reconstruction for serious damaged hands

From Dec. 1992 to Feb. 1995, eight patients with serious damage of forearms and hands were treated with early reconstruction. Based on the location and severity of damage different methods were used, including: 1. Vesection of damaged segment, transpositioned replantation of palm or finger, free second toe with dorsal podal flap. lateral lower leg flap transfer for thumb reconstruction and wound covering; 2. transpositioned finger replantation, free second toe with dorsal pedal flap transfer for thumb or finger reconstruction and wound covering; 3. second toe with dorsal pedal flap transfer for thumb reconstruction at carpometarcarpal level, index reconstruction with second metacarpal, flap transfer for wound covering. After follow-up for 6 months to 2 years, all the patients returned to previous works with partial functional restoration. We suggest that complex tissue grafts should be used with transpositioned replantation if possible for seriously damaged hands.