中华显微外科杂志
中華顯微外科雜誌
중화현미외과잡지
Chinese Journal of Microsurgery
2012年
1期
16-19
,共4页
李崇杰%辛畅泰%梁晓旭%沙德峰%姚阳%车敏%于灏%田芙蓉%陈兵
李崇傑%辛暢泰%樑曉旭%沙德峰%姚暘%車敏%于灝%田芙蓉%陳兵
리숭걸%신창태%량효욱%사덕봉%요양%차민%우호%전부용%진병
跖趾关节%掌指关节%趾间关节%显微外科手术
蹠趾關節%掌指關節%趾間關節%顯微外科手術
척지관절%장지관절%지간관절%현미외과수술
Metatarsophanlangeal joint%Metacarpophalangeal joint%Interphalangeal joint%Microsurgical operation
目的 探讨吻合血管的足部跖趾及指间关节移植修复手部掌指关节及指间关节缺损的临床疗效. 方法 自1993年4月至2010年11月,分别对4例掌指关节及5例近位指间关节和3例掌指关节连同近位指间关节一并缺损的患者,应用吻合血管的第二跖趾关节、近位趾间关节或同一足趾的跖趾关节连同近位指间关节一并移植进行修复. 结果 12例关节移植均全部成活,术后创口均一期愈合,移植关节的骨愈合时间为5～ 10周,术后随访时间为4～ 28个月.移植关节均无明显骨及关节的退变.其修复后的掌指关节伸屈活动为0°～70°,近位指间关节的伸屈活动10°～90°,参照关节活动度TAM/TAF评定标准评定:优5例,良4例,可2例,差1例,优良率为75％. 结论 应用吻合血管的跖趾关节及趾间关节移植修复掌指关节及指间关节缺损,其愈后功能恢复比较满意,关节活动能达到基本正常的工作和生活需求,可获得较好的关节功能.
目的 探討吻閤血管的足部蹠趾及指間關節移植脩複手部掌指關節及指間關節缺損的臨床療效. 方法 自1993年4月至2010年11月,分彆對4例掌指關節及5例近位指間關節和3例掌指關節連同近位指間關節一併缺損的患者,應用吻閤血管的第二蹠趾關節、近位趾間關節或同一足趾的蹠趾關節連同近位指間關節一併移植進行脩複. 結果 12例關節移植均全部成活,術後創口均一期愈閤,移植關節的骨愈閤時間為5～ 10週,術後隨訪時間為4～ 28箇月.移植關節均無明顯骨及關節的退變.其脩複後的掌指關節伸屈活動為0°～70°,近位指間關節的伸屈活動10°～90°,參照關節活動度TAM/TAF評定標準評定:優5例,良4例,可2例,差1例,優良率為75％. 結論 應用吻閤血管的蹠趾關節及趾間關節移植脩複掌指關節及指間關節缺損,其愈後功能恢複比較滿意,關節活動能達到基本正常的工作和生活需求,可穫得較好的關節功能.
목적 탐토문합혈관적족부척지급지간관절이식수복수부장지관절급지간관절결손적림상료효. 방법 자1993년4월지2010년11월,분별대4례장지관절급5례근위지간관절화3례장지관절련동근위지간관절일병결손적환자,응용문합혈관적제이척지관절、근위지간관절혹동일족지적척지관절련동근위지간관절일병이식진행수복. 결과 12례관절이식균전부성활,술후창구균일기유합,이식관절적골유합시간위5～ 10주,술후수방시간위4～ 28개월.이식관절균무명현골급관절적퇴변.기수복후적장지관절신굴활동위0°～70°,근위지간관절적신굴활동10°～90°,삼조관절활동도TAM/TAF평정표준평정:우5례,량4례,가2례,차1례,우량솔위75％. 결론 응용문합혈관적척지관절급지간관절이식수복장지관절급지간관절결손,기유후공능회복비교만의,관절활동능체도기본정상적공작화생활수구,가획득교호적관절공능.
Objective To discuss the clinical effect of repairing metacarpophalangeal and interphalangeal (finger) joint defects by transferring metatarsophalangeal and interphalangeal (foot) joint with vascular anastomosis. Methods From April 1993 to November 2010,four cases of metacarpophalangeal joints,five cases of proximal interphalangeal joints and 3 cases of both joints defects were repaired by the second metatarsophalangeal joint,PIP joint and both joints transplantation with vascular anastamosis. Results All 12 cases of grafted joints survived.Primary postoperative healing was achieved,the bone healing time was 5 to 10 weeks.The duration of postoperative follow up was 4 to 28 months, no degeneration of grafted joints was found except in 1 case with degenerative change of the metatarsal head. The postoperative range of motion (ROM) in the transferred metacarpophalangeal joint was 0° to 70°,and ROM of the PIP was 10° to 90°.Graded according to TAM/TAF scale,the outcomes of this series were excellent in 5 cases,good in 4 cases,fair in 2 cases,poor in 1 case.The overall excellent and good rate was 75％. Conclusion Repair of metacarpophalangeal and interphalangeal (finger) joint defects using metatarsophalangeal and interphalangeal (foot) transplantation with vascular anastamosis enables favorable functional recovery and joint movement that meets daily needs,providing satisfactory functional improvement of the joints.
