前臂解剖特点与上臂离断再植成败的关系

目的 探讨前臂解剖对断臂再植成败的影响。方法 断臂再植病例62例,成功57例,失败5例。结果 断臂再植成功主要受断肢热缺血时间、前臂挫伤、静脉回流的影响。三者可引发前臂骨筋膜室综合征,进一步导致肌肉缺血液化坏死,血管腐蚀,供血丧失,再植失败,术后出现前臂骨筋膜室综合征时及时切开减压和术前预防性前臂切开减压,可使断臂顺利成活,显著提高断臂再植的成活率。结论 肌肉缺血液化坏死是断臂再植失败的主要因素。前臂骨筋膜室的存在容易引起肌肉缺血液化坏死。前臂骨筋膜室与断臂再植的成败有很大关系。

The relationship between forearm anatomy and upper arm replantation.

Objective Realize the relationship between the forearm anatomy and upper arm replantation. Methods 62 cases of replanting amputated upper arm. 57 cases were successful, 5 cases failed. Results The success of replanting upper arm is affected mainly by ischemia-reperfusion injury,soft tissue injury of forearm and failure of venous return, they result in compartment syndroms of foream, then ischemia, colliquation, necroses of tissue would be caused,vessels may be eroded,the supply of blood disappear at last relief incision of forearm that is operated as soon as compartment syndroms of forearm appear and operated preventively as replanting can make the replanted upper arms survived smoothly and raised remarkedly the level of replanted upper arm survival rate. Conclusions The main failure factor of replanting upper arm is ischemia, colliquation and necroses of muscles that may happen easily at forearm while forearm compartment syndroms appear. Forearm compartment has a great relationship with the success of upper arm replantation.