邻指指固有动脉移位在末节断指再植中的临床应用

目的 探讨挤压，旋转撕脱性末节断指的再植方法。方法 对15例15指该类末节断指，应用邻指指固有动脉移位与断指远端指动脉吻合重建血运，将两指创面合并缝合后用外固定固定35－45d，平均39d。经行邻指指固有动脉阻断训练确认断指侧枝血液循环已建立，二期进行血管断离和分指术。结果 15指末节断指全部成活。术后1例失访，14例随访6－13个月，平均9．5个月。按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10例，良3例，可1例，优良率为92．9％。结论 因挤压，旋转撕脱伤所致末节断指无法实施原位血管直接吻合的病例，应用邻指指固有动脉移位重建末节断指血液循环，是一种有效的再植方法。

Clinical application of transfer of neighboring digital proper artery in replantation of severed finger tips

Objective To explore the replantation of severed finger tips with crushed and rotation avulsion injury.Methods 15 cases (15 fingers) of severed finger tips were involved. Neighboring digital proper artery were transferred to anastomose with digit artery of the distal severed stump. The wound of the two fingers were sutured together and fixed externally for 35 to 45 days ( an average of 39 days).After interruption of the neighboring digital proper artery was carried out to reestablish the lateral blood circulation of the severed finger, then vessel dissection and finger separation were done at the second stage.Results 15 cases (15 fingers) of severed finger tip were survived. After operation, the follow up period ranged from 6 to 13 months (an average of 9.5 months). There was 1 case in loss of follow up. According to the standard functional evaluation issued by Hand Surgery Association of Chinese Medical Association, the results were excellent in 10, good in 3, fair in 1, with excellent and good rate 92.9 %. Conclusions For the severed finger tips resulting from crushed and rotation avulsion injuries , direct anastomosis of vessel in situ was impossible. However, transfer of neighbouring finger proper artery was done to reconstruct the blood circulation of the severed finger is an effective procedure for replantation.