多指节段性毁损性离断再植

目的 扩大断指再植适应证，提高断指再植术后功能的恢复。方法 1996年2月-1999年8月，对8例23指节段性毁损性断指进行缩短再植，骨支架行克氏针固定，18指修复了指伸、屈肌腱，每指均吻合单侧（6指）或双侧（17指）指固有神经，动、静脉吻合比为1：2或2：3，血管缺损5指8条，行自体静脉游离移植，结果 8例23指再植全部成活，5指二期行DIP融合术，术后随访10-18个月，1指锤状指畸形，余各指痛，温觉恢复，两点辨别觉6-12mm，患手恢复了捏夹，钩提及抓握等基本功能。结论 多指节段性毁损性离断进行缩短再植对恢复手的功能有益。

REPLANTATION OF SEGMENTAL DESTRUCTIVE AMPUTATION OF MULTIPLE FINGERS

Objective To discuss the indication of replant ation of destru ctive amputation of multiple fingers for improvement of the function of injured fingers. Methods From February 1996 to August 1999, 23 ampu tated fingers in 8 cases were shortened and replanted. The crushed digital bones were fixed by Kir schner wires, flexor tendons repaired by Kessler suture technique, and digital e xtensor tendons repaired by mattress suture. The arteries and veins were anastom osed in each finger at the ratio of 1 to 2 or 2 to 3. The defect of blood vessel s was repaired by free graft of autologous veins in 5 fingers. All of the cases were followed up for 10 to 18 months, and clinical evaluation was performed. Results All replanted fingers survived in the 8 cases, with go od sensation, two point discrimination of 6 to 12 mm, and satisfied function, such as pinching, gr asping and hooking. The fingers were shortened for 2.6 cm in average, ranging fr om 2.2 cm to 4.0 cm. Conclusion Multiple digits replantatio n by shortening f ingers is beneficial to functional restoration of segmental destructive fingers.