复杂性拇指离断的再植治疗

目的探讨复杂性拇指离断的再植术式和治疗效果。方法对56例伴有不同程度软组织缺损的复杂性拇指离断，采用单纯血管移植、静脉皮瓣移植、示指背侧岛状皮瓣转移、示指桡侧指动脉转位、示指桡侧指动脉蒂岛状皮瓣和静脉动脉化的再植方法及示指固有伸肌腱、环指屈指浅肌腱转位修复肌腱缺损方法。结果成活50例，失败6例，成活率89％。42例获得随访，随访时间5～25个月。断指再植功能评定：优10例，良25例，差7例，优良率83％。结论复杂性拇指离断可采用非常规方式再植且再植，疗效满意。

Replantation to treat complex thumb severance

Objective To discuss the methods and effects of replantation to treat complex thumb severance. Methods 56 cases of complex thumb severance combined with soft tissue defects were treated with simple vessel transplantation, veno flap transplantation, dorsal index digital island flap transplantation, digital artery transfer, transfer of radial index digital artery pedicled island flap, or veno arteriolization. The soft defects were repaired by the transfer of extensor index finger tendon and superficial ring finger flexor tendon. Results 50 cases survived and 6 cases failed, with the survival rate being 89%. 42 cases were followed up for 5 to 25 months. The function of the treated thumbs was assessed as excellent in 10, good in 25 and bad in 7. The excellent and good rate was 83%. Conclusion Complex thumb severance can be treated by unconventional replantation so as to achieve good effects.