拇指旋转撕脱离断伤再植方式的探讨和选择

目的：探讨拇指旋转撕脱离断再植方法的选择、各种术式的优缺点及临床疗效。方法：2009年2月至2012年3月治疗21例拇指旋转撕脱离断伤患者，男16例，女5例；年龄16～45岁，平均32岁。根据患者手指撕脱情况应用不同方法行断指再植术，术后观察患者成活情况及再植指术后功能康复情况。结果：21例再植指，成活19例，失败2例。成活的19例进行随访，时间3～14个月，平均8个月。根据中华医学会手外科学会断指再植功能评定试用标准评定：优13例，良5例，差1例。结论：按照拇指旋转撕脱离断伤不同情况采用不同再植方法，可获得较高的成活率，并能恢复较好的外形与功能。

Investigation of replantation of thumb rotation avulsion injury

Objective: To investigate replantation methods and clinical outcomes of thumb rotation avulsion injury,and to evaluate the advantages and disadvantages of each procedure. Methods: From Feburary 2009 to March 2012,21 thumbs suffered from rotation avulsion injuries and replanted by different methods,including 16 males and 5 females with an average age of 32 years old ranging from 16 to 45 years old. Diffierent methods were chosen according to the traumatic condition. And the survival condition and function of the thumbs after replantation were observed and evaluated. Results: Among them,19 replanted figers were survival,2 cases failed. The mean follow-up period was 8 months (ranged from 3 to 14 months). According to the criteria for function assement of amputated finger issued by the Branch of Hand Surgery of Chinese Medicine Association,the results were excellent in 13 cases,good in 5,and poor in 1. Conclusion: According to the traumatic condition to choose various approach in replantation of thumb with rotation avulsion,leading to a higher success rate,and provide the patients with a more aesthetic appearance and satisfied function.