CAJ | 학술논문

目的：探讨手指末节脱套伤的损伤特点及再植方法。方法：2004年至2009年，对18例19指末节脱套伤患者进行吻合血管再植术，男14例，女4例；年龄18～51岁，平均31岁。根据术中指动脉与撕脱皮肤撕脱平面不同分为3型，其中Ⅰ型6指，Ⅱ型10指，Ⅲ型3指。3例4指血管损伤严重终止再植，15例15指采用显微吻合血管方法再植。结果：15例完成手术者中，13例13指成活，2例2指术后坏死。13例成活指随访6～24个月，平均14个月，伤指外形及指甲生长外观满意。按中华医学会手外科学会断指再植功能评定试用标准评定，优9例，良3例，差1例。结论：末节脱套伤再植效果好，应尽量争取再植。
목적：탐토수지말절탈투상적손상특점급재식방법。방법：2004년지2009년，대18례19지말절탈투상환자진행문합혈관재식술，남14례，녀4례；년령18～51세，평균31세。근거술중지동맥여시탈피부시탈평면불동분위3형，기중Ⅰ형6지，Ⅱ형10지，Ⅲ형3지。3례4지혈관손상엄중종지재식，15례15지채용현미문합혈관방법재식。결과：15례완성수술자중，13례13지성활，2례2지술후배사。13례성활지수방6～24개월，평균14개월，상지외형급지갑생장외관만의。안중화의학회수외과학회단지재식공능평정시용표준평정，우9례，량3례，차1례。결론：말절탈투상재식효과호，응진량쟁취재식。
Objective:To explore clinical characteristics and replantation methods of degloving injury of distal finger. Methods:From 2004 to 2009,18 cases of 19 distal finger degloving were admitted,and included 14 males and 4 femals with an average age of 31 years old ranging from 18 to 51 years old. The distal finger degloving injury was divided into 3 types according to the different levels of degloveing digital artery and skin involving 6 fingers of typeⅠ,10 fingers of typeⅡ,3 fingers of typeⅢ. A-mong them,3 cases of 4 fingers were failed to be replantaed due to severed injured digital artery,and 15 cases of 15 distal finger degloving injury were replanted with microsurgical technique. Results:Among 15 patients (15 fingers) conpleted the reimplant operation,13 fingers were survived,2 fingers were necrosis after operation. Thirteen survived fingers were followed up from 6 to 24 months (averaged 14 months). The appearance of injured fingers and nails obtained satisfactory results. According to Chinese Hand Surgery Society Criteria for function assessment replantation,the results were excellent in 9 cases,good in 3 cases and poor in 1. Conclusion:Replantation of distal degloving injury is effective and it should strive for replantation.