摘要
目的 评价扩大骨髓腔的末节断指再植术的可行性及临床效果。方法 对 2 6例 2 9个离断手指末节进行扩大骨髓腔的再植术。术中扩大断指近、远侧骨段髓腔 ,使其复位后骨髓腔保持相通 ,用一根直径 0 .8～ 1.0mm克氏针和 /或一个 7号注射针头固定骨支架 ,每指吻合末端指动脉或末端指动脉弓上分支 1～ 2条 ,缝接指神经终末支 2条。结果 2 6例 2 9个离断手指末节再植全部成活。术后随访 4～ 12个月 ,平均 8.5个月 ,除 2指指甲缺如外 ,手指末节外形良好 ,痛、温觉恢复 ,指腹两点辨别觉为 4～ 10mm。结论 在末节断指再植术中 ,当断指无静脉可供吻合时 ,扩大骨髓腔是解决静脉回流的简便、有效方法 ,能扩大断指再植适应证 ,提高再植成活率。
Objective To assess the feasibility and clinical effectiveness of distal digital replantation with reamed medullary cavities.Methods 29 amputated fingers in 26 cases were replanted with reamed medullary cavities. Medullary cavities of the distal fragment and the proximal fragment of the severed finger were reamed and made unobstructed. The bones were fixed using one Kirschner wire of a diameter ( 0.8 - 1.0 mm)and /or a 7 garge hypodermic needle in each finger after reduction of fracture. One or two digital arteries/the branches of the terminal arteries were anastomosed and two digital nerves sutured in each finger.Results All replanted fingers survived in 26 cases. The average postoperative follow up was 8.5 months, ranging from 4 to 12 months. Near normal appearance and satisfactory sensation of the distal phalanx with 2 PD of 4 10 mm were obtained but two nail loss.Conclusion When there were no suitable veins for microsurgical repair in distal digital replantation, reaming medullary cavity was a simple and reliable method for establishing a venous drainage. It could expand indication of the replantation and improve the survival rate.
出处
《华中医学杂志》
2002年第4期179-180,176,共2页
Central China Medical Journal
