静脉移植和吻合掌侧静脉在不同平面末节断指再植中的应用

目的 探讨不同平面末节断指的再植方法.方法 2004-2007年,对63例71指末节断指,按损伤部位分为4区,采用静脉移植和吻合掌侧静脉的方法进行再植.结果 术后71指存活70指.随访时间为3个月至3年,再植手指饱满,手指长度正常,指甲外观满意.再植指两点分辨觉平均为6.5 mm,除Ⅳ区关节融合者外,其余拇指指间关节与远侧指问关节活动度平均为69°.结论 对末节断指的处理,为保留手指长度和指甲,血管移植修复是必要的,尤其是Ⅱ区和Ⅲ区,同时行掌侧静脉吻合对末节再植的成功至关重要.

Venous graft and volar venous anastomosis in distal phalanx replantation

Objective To explore the methods of distal finger replantation at different levels.Methods Sixty-three cases with 71 fingers severed at distal phalanx level were replanted from 2004 to 2007.The distal phalanx was divided into 4 zones as described by lshikawa.Vein grafting and anastomosis of volar distal veins were employed according to the injury zone. Results Seventy replanted fingers survived.FoUow-up ransed from 3 months to 3 years.The replanted fingers had full pulp and normal length.Nail growth Was normal.Two-point discrimination was 6.5 mm on average.Except cases with zone Ⅳ iniury in which arthredesis was-done,the average range of motion of the interphalangeal joint Was 69°. ConclusionIn distal finger replantation venous graft is necessary in order to maintain the length of the finger and preserve the nail.This is especially true in zoneⅡand zone Ⅲ injuries.Anastomosis of volar veins is key to replantation survival.