功能不良再植断指的原因分析

目的 寻找再植指功能不良的原因，提高断指再植的功能疗效。方法 对无锡市手外科医院因工伤纠纷、医疗投诉、伤残鉴定、再入院手术和手再度受伤的入院病例，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，可、差级者共73例134指，均属功能不良。结合创伤和手术情况，进行了回顾性分析。结果 134指运动功能全部不良，伴感觉恢复不良58指，外观不良26指，伴血液循环不良24指，伴血液循环、感觉、外观等二项以上不良26指。结论 创伤严重可导致再植指功能不良，但再植指征过宽，内固定技术失当，不重视康复训练，是再植指功能不良的重要原因，临床医师必需高度重视。

Assessment of functional impairment after replantation of amputated finger

Objective To find out the cause of poor functional restoration after replantation of amputated finger, and to improve its treatment outcome. Methods The patients involved in the study were from Wuxi Hand Surgery Hospital, including those with dissension of industrial accident, medical litigation, identification of injury degree, readmission for secondary operation and rewounded injury in the hand. According to the criteria for functional assessment of amputated finger issued by the Branch of Hand Surgery of Chinese Medicine Association, all 73 cases (134 lesions) were divided into fair and poor functional impairment result. A retrospective analysis was done in combination with the condition of trauma and operation. Results All 134 fingers had limited range of motion. There were poor sensation 58 fingers, malformation 26 fingers, insufficiency of blood supply 24 fingers. Twenty-six cases had 2 or 3 items of poor sensation, malformation and insufficiency of blood supplying. Conclusion Poor functional restoration of amputated finger can result from severe trauma. However, more importantly, it was originated from lack of rigid surgical indication, improper internal fixation technique and ignorance of rehabilitation. More attentions should be paid by clinicians.