CAJ | 학술논문

目的探讨应用组织移植一期修复手掌冲压性贯通伤的临床效果.方法 2001年5月至2010年8月,对18例手掌冲压性贯通伤,急诊清创后一期行组织移植修复.其中皮肤并掌指关节缺损11例,行携带皮瓣的跖趾关节移植修复;皮肤并掌骨缺损7例,取髂骨植骨以哑铃状股前外侧皮瓣移植修复.结果 18例移植组织全部存活,随访1～9年,手功能恢复按中华医学会手外科学会上肢部分功能评定试用标准评定:优4例,良10例,可3例,差1例;优良率为77.8％.结论应用显微外科方法一期行组织移植修复手掌冲压性贯通伤所致皮肤、骨、肌腱、神经等组织缺损,可有效缩短疗程,最大程度地恢复手功能.
목적 탐토응용조직이식일기수복수장충압성관통상적림상효과.방법 2001년5월지2010년8월,대18례수장충압성관통상,급진청창후일기행조직이식수복.기중피부병장지관절결손11례,행휴대피판적척지관절이식수복;피부병장골결손7례,취가골식골이아령상고전외측피판이식수복.결과 18례이식조직전부존활,수방1～9년,수공능회복안중화의학회수외과학회상지부분공능평정시용표준평정:우4례,량10례,가3례,차1례;우량솔위77.8％.결론 응용현미외과방법일기행조직이식수복수장충압성관통상소치피부、골、기건、신경등조직결손,가유효축단료정,최대정도지회복수공능.
Objective To explore the clinical effect of one-stage repair of stamping and penetrating wound in the palm with tissue transplantation.Methods From May 2001 to August 2010,18 patients whose palms got stamping and penetrating injuries were treated with immediate debridement and one-stage repair with tissue transplantation.Among them,11 had skin and metacarpophalangeal joint defect and received transfer of composite skin flap and the metatarsophalangeal joint.The other 7 sustained skin and metacarpal bone loss and had iliac bone graft along with transfer of dumbbell-shaped anterolateral thigh flap.Results All 18 cases were successful with complete survival of all the transplanted tissues.Postoperative follow-up ranged from 1 to 9 years.Recovery of the hand function was evaluated using the criteria issued by the Hand Surgery Society of the Chinese Medical Association and was rated as optimal in 4 cases,good in 10 cases,fair in 3 cases and poor in 1 case,achieving a 77.8％ satisfactory rate.Conclusion Treating patients with stamping and penetrating palm injuries with skin,bone,tendon and nerve tissue defect with one-stage micmsurgical tissue transplantation could effectively shorten the period of treatment and restore hand function.