无可供吻合静脉的指尖离断再植

【目的】探讨无可供吻合静脉的指尖离断再植的方法及临床效果。【方法】对59例66指无可供吻合静脉的指尖离断分别以三种血运重建方式行再植术：吻合双侧指动脉、结扎一例近端指动脉（22例27指）；吻合1条指动脉、扩大近端骨髓腔经骨髓腔静脉回流（13例15指）；仅吻合指端动脉弓分支通过指动脉吻合口近端的侧支回流（24例24指）。【结果】再植59例66指，成活61指，成活率为92．4％。随访6～24个月，再植指指腹饱满，指甲生长良好，两点辨别觉4～7mm，外观及功能满意。【结论】对无可供吻合静脉的指尖离断，根据其血管条件，选用不同的血运重建方式行再植术，效果良好。

Replantation of Amputated Fingertip Without Available Vein

Objective] To explore the clinical effect of the replantation of amputated fingertip .without available vein. Methods] Sixty six amputated fingertips in 59 cases were replanted by using three ways of vascular reconstruction including anastomose of both sides of arteria digitalis and ligation of one side of proximal arteria digitalis in 27 fingers of 22 cases, anastomose of one side of arteria digitalis to return through medullary canal vein by enlarging the proximal cavity Of bones in 15 fingers of 13 eases, and just anastomose of the branch of arterial arcades to return through the branch of the proximal stoma of arteria digitalis in 24 fingers of 24 cases. Results]In 66 fingers of 59 cases, 61 survived. The survival rate was 92.4%. In the follow-up with 6-24 months, the replanted fingers grew well with satisfactory appearance and function. The two-point discrimination was 4-7mm. Conclusion] According to the condition of blood vessel, performing the replantation by using different ways of vascular reconstruction has good effect in the treatment of the amputated fingertip without available vein.