手指末节完全离断原位缝合再植的疗效分析

目的:探讨提高末节断指原位缝合成活率的治疗方法和疗效.方法:58例76指完全离断指,按范启申末节再植Ⅴ分类,Ⅰ类33指、Ⅱ类29指、Ⅲ类12指、Ⅳ类2指.其中未成年人Ⅰ类7指、Ⅱ类3指.显微镜下探查,无血管吻合条件后原位缝合再植.术后辅助高压氧治疗.结果:本组76指55指成活,成活率72.36%,其中Ⅰ类29指全部成活,成活率87.87%,Ⅱ类20指全部成活,成活率68.97%.其中未成年人Ⅰ类7指、Ⅱ类2指全部成活,成活率90%.成活指大部外形、感觉良好.结论:对无血管吻合条件的末节适当处理原位缝合再植,可取得良好疗效,特别是Ⅰ类、Ⅱ类及儿童断指再植,不可轻易放弃.

Analysis on curative effect of using original suture to replant distal part of complete amputated fingers

Objective：To report the curative effect and experience of using original suture to replant distal part of complete amputated fingers.Methods：76 distal part of complete amputated fingers of 58 cases were replanted by using original suture.According to the Fan Qi-shen classification for replantation of distal part of amputated finger,there were 33 typeⅠ,29 type Ⅱ,12 type Ⅲ amputated fingers and 2 type Ⅳ amputated fingers.There were 7 typeⅠ,3 type Ⅱ amputated fingers in children.Assisted hyperbaric oxygen therapy was conducted postoperatively.Results：55 of 76 fingers were survival with the survival rate of 72.36%.29 type Ⅰfingers were survival with survival rate of 87.87%.20 type Ⅱfingers were survival with the survival rate of 68.97%.7 typeⅠand 2 type Ⅱ amputated fingers in children were survival with the survival rate of 90%.According to the criteria for functional assessment of amputated finger issued by the Branch of Hand Surgery of Chinese Medicine Association,the excellent and good rate was 82.3%.Conclusion：Through proper manipulation,using original suture to replant distal part of complete amputated fingers has a good curative effect,especially in typeⅠ,2 type Ⅱ amputated fingers and children.