严重压砸性断掌再植与功能重建

目的 报道严重压砸性断掌的显做外科治疗方法。方法 根据手掌部不同平面的毁损性断掌，采用移植血管桥接的断掌再植、腕掌部切除手指的前臂再植、断掌再植合并拇指再造等最大限度地保留部分手或手指。结果 本组14例．有3例断掌再植中食指坏死，其余均成活，通过康复训练，11例随访半年以上．其中10例恢复了对指功能，1例接近正常手，均恢复了对指功能，两点分辨觉8～10mm。结论 严重压砸性断掌进行合理的断掌再植仍是恢复部分手功能的一种方法。

Replantation and functional reconstruction of severed palm caused by crush injury

Objective To report microsurgical treatment of severed palm caused by crush injury. Methods From 1998 to 2002, 14 patients with severed palm and destructive crush injury were treated in our hospital. According to the specific severity and level of different injuries, replantation of severed palm with vessel transfer, replantation of fingers to the distal forearm with resection of wrist and palm, replantation of severed palm combined the thumb reconstruction were applied to reserve a maximal part of hand or fingers. Results Of the 14 cases of replantation, 3 experienced death of middle or index finger and the others all survived. The follow up of 11 cases lasted more than 6 months. After functional exercises, 10 cases recovered the function of pinch, and 1 case nearly regained normal functions. All of them regained sensation and the two point discrimination was 8 to 10 mm. Conclusion Reasonable replantation for severed palm with crush injury is still a method to regain part of hand functions.