腕、掌部毁损的急诊手再造

目的 报告腕、掌部毁损伤利用残指移位再植于前臂远端急诊手再造的经验和方法.方法 对4例腕、掌部毁损伤的患者,利用显微外科技术将残指移位再植于桡、尺骨远端,结合术后系统的功能锻炼,重建部分手功能.结果 4例再造手全部存活.随访时间最长20年,最短1年;再造手恢复了部分屈伸、握持、对掌功能,指腹两点分辨觉为5～7mm.结论 对于腕、掌部毁损伤的患者,将残指移位再植于前臂残端,重建手指屈伸和对掌功能,是治疗该类损伤较为理想的方法.

Emergency reconstruction of mutilating injuries of the wrist and palm

Objective To report the experience and methods of emergency hand reconstruction in mutilated wrist and hand injuries by replantafion of salvageable fingers to the distal forearm stump. Methods Four patients of mutilating injury of the wrist and palm were treated with this approach. Immediately following debridement the salvageable fingers were replanted to the distal stumps of the ulna and radius. Systematic rehabilitation was carried out to restore partial function of the hand. Results All 4 reconstructed hands survived. Follow up period ranged from 1 to 20 years. The hands had some extent of flexion and extension, grasping and opposition function. Two point discrimination is 5-7 mm Conclusion For patients with mutilating injury of the wrist and palm, replanting fingers to the distal stump of ulna and radius is an ideal method to restore part of hand function.