CAJ | 학술논문

目的探讨一种改良的手指末节离断的再植方法.方法对9例手指末节甲根平面以远离断伤,清创后采用指骨短缩克氏针固定、显微镜视下吻合两侧指动脉和指神经,再于手指近节非优势侧将远端非优势侧动脉与近端静脉吻合,建立患指的非生理性血液循环.结果术后9例手指均存活.随访时间为3～ 12个月,患指外观满意,指甲平整,关节活动良好,两点分辨觉8～10 mm.结论采用适当平面动脉静脉化进行手指末节离断再植,不仅可以降低手术难度,还可以提高断指成活率.
목적 탐토일충개량적수지말절리단적재식방법.방법 대9례수지말절갑근평면이원리단상,청창후채용지골단축극씨침고정、현미경시하문합량측지동맥화지신경,재우수지근절비우세측장원단비우세측동맥여근단정맥문합,건립환지적비생이성혈액순배.결과 술후9례수지균존활.수방시간위3～ 12개월,환지외관만의,지갑평정,관절활동량호,량점분변각8～10 mm.결론 채용괄당평면동맥정맥화진행수지말절리단재식,불부가이강저수술난도,환가이제고단지성활솔.
Objective To develop a new method for replantafion of fingers severed at the distal phalanx level. Methods Nine fingers severed at the level distal to the nail base were replanted.After debridement,the phalanx was shortened and fixed with Kirschner wires.Digital nerves and arteries of both sides were anastomosed under the microscope.More proximally on the non-dominant side,the distal digital artery was anastomosed to the proximal vein to establish non-physiological blood circulation for venous drainage. Results All 9 fingers survived.Follow-up period ranged from 3 to 12 months.Satisfactory appearance,smooth nail and good active range of motion were achieved.Two-point discrimination was between 8 to 10 mm. Conclusion Sacrificing one digital artery to reconstruct venous system in fingertip replantation can effectively increase survival rate.