摘要
目的对末节断指进行临床研究和分型，提高再植成活率。方法再植末节断指５３０例６４５指。在手术显微镜下观察３６指毁损指末节的血管、神经分布。结果末节断指分成三型。Ⅰ型：离断部位自远节指间关节横纹至甲根部，共４３４指；Ⅱ型：甲根部至指腹螺纹中心（包括斜面离断），共１３７指；Ⅲ型：指腹螺纹中心以远，共７４指。Ⅰ、Ⅱ型的动脉口径为０．３ｍｍ～０．６ｍｍ，指背和指腹侧静脉口径为０．３ｍｍ～０．８ｍｍ。Ⅲ型的指动脉呈分支状，口径０．１ｍｍ～０．３ｍｍ，静脉口径０．１５ｍｍ～０．３ｍｍ。三型再植成活率分别为９７．７％、９５％和９７％，再植指感觉恢复良好，外形满意。结论Ⅰ、Ⅱ型末节断指需在１０倍手术显微镜下吻合血管，Ⅲ型应在放大１６倍镜下吻合血管。
Objective To study and classify the severed
distal segment of fingers and increase the survival rate of replantation. Methods 645 severed
distal segments of fingers in 530 cases were studied. The distribution of blood vessels and
nerves in the distal segment were observed under microscope using 36 mutilated fingers.
Results Severance of the distal segments could be classified into 3 types according to the level
of amputation: type , between the distal interphalangeal joint and nail root; type , between the
nail root and the center of swirling fingerprint; and type, distal to the center of swirling
fingerprint. 434 fingers of this series were categorized as type. And there were 137 and 74
fingers classified into type and type respectively. In typeand , the diameter of the arteries was
around 0.3 to 0.6 mm, and that of the veins was 0.3 to 0.8 mm. In type , the artery was ramified,
with diameter of 0.1 to 0.3 mm. The diameter of the veins was 0.15 to 0.3 mm. The survival rate
after replantation was 97.7 %, 95 %, and 97 % respectively. The replanted fingers had
satisfactory sensation and appearance. Conclusions The severed distal segment of fingers in
typeand type should be replanted under 10 magnification. The vessels of the fingers in type
should be anastomoses under 16 magnification.
出处
《中华手外科杂志》
CSCD
1999年第2期101-103,共3页
Chinese Journal of Hand Surgery
