铡草机致多指、多节段指体离断的再植

目的 探讨铡草机所致不同类型断指的手术方法 和疗效.方法 单手指再植,应用传统方法 再植;多指、多节段再植应根据伤情、人员组成、再植的顺序等方面进行合理的规划后有序的进行再植;无再植条件的指体则进行残修、皮瓣修复或足趾再造.结果 36例患者离断79指、再植69指、成活63指,成活率91.3%.术后随访3月～2年,按中华医学会手外科分会断指再植功能评定试用标准评定：优44,良10,可6,差3,优良率85.7%.结论 铡草机所致的不同断指经严格掌握再植适应症、周密的手术计划与术中精细操作、术后精心护理和早期功能锻炼,再植指体存活率高,外观及功能良好.

Replantation surgery of multiple amputated digital and phalanges by chaff cutter

Objective To study the surgical methods and healing effect of different sorts of amputated digits by chaff cutter. Methods Single digit replantation was generally treated with traditional surgery, while multiple amputated digital and phalanges should be replanted logically and orderly according to several aspects, such as condition of the injury, staff, order of replantation and so on.The digit without replanting conditions should be treated with disabled repair, flap repair and toe recycling. Results 69 digits of 79 digits from 36 patients were replanted, and 63 digits of them survived, thus the successful rate was 91.3%. The follow-up ranged from 3 months to 2 years, Judgement was made according to the amputated digit replatation trial standard of Hand Surgery Branch of Chinese Medical Association： 44 cases were superior degree, 10 cases were fine degree, 6 cases were common degree and 3 cases were poor degree, acceptance rate was 85.7%.Conclusion Different amputated digits by chaff cutter recovered well with high digits survival rate and fine appearance and function after evaluate replantation indication strictly, careful surgical planning, intraoperative fine operation, postoperative intensive care and early functional exercise.