CAJ | 학술논문

目的探讨婴幼儿手指撕脱离断再植的手术方法和适应证.方法 2009年12月至2013年6月,应用显微外科技术对12例6个月至3岁患儿手指撕脱离断进行再植,8例原位再植,4例行关节融合,撕脱肌腱一期或二期转位修复,术中血管、神经缺损,应用血管移植,血管翻转桥接神经,术后长臂石膏托固定.结果术后1例拇指指体坏死,行第二足趾再造,余指体全部存活.随访6个月至3年,按中华医学会手外科学会上肢部分功能评定试用标准进行手功能综合评定:优4例,良5例,可1例,差2例.结论婴幼儿撕脱断指只要指体完整,无手术禁忌证,应用血管移植桥接神经缺损,术后效果满意.
목적 탐토영유인수지시탈리단재식적수술방법화괄응증.방법 2009년12월지2013년6월,응용현미외과기술대12례6개월지3세환인수지시탈리단진행재식,8례원위재식,4례행관절융합,시탈기건일기혹이기전위수복,술중혈관、신경결손,응용혈관이식,혈관번전교접신경,술후장비석고탁고정.결과 술후1례무지지체배사,행제이족지재조,여지체전부존활.수방6개월지3년,안중화의학회수외과학회상지부분공능평정시용표준진행수공능종합평정:우4례,량5례,가1례,차2례.결론 영유인시탈단지지요지체완정,무수술금기증,응용혈관이식교접신경결손,술후효과만의.
Objective To investigate the surgical methods and indications for replantation of avulsion amputated fingers in infants and toddlers.Methods From December 2009 to June 2013,twelve avulsion amputated fingers of infant patients,age 6 months to 3 years,were replanted microsurgically.Among these 8 cases were treated with in situ replantation while 4 with arthrodesis plus tendon transposition at the same stage or a later stage.Vascular grafting and nerve bridging with vascular flip were used when indicated.Postoperatively the limb was immobilized in a long arm cast.Results All the replants survived except one thumb necrosis which was removed and repaired with a second toe transplantation.During the 6 months to 3 years postoperative follow-up,functions of the affected hands were assessed.According to the upper extremity functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association,the results were rated as excellent in 4 cases,good in 5 cases,fair in 1 case and poor in 2 cases.Conclusion As long as the avulsion amputated fingers are intact and there is no contraindication,replantation surgery should be performed.Vascular grafting and nerve bridging by vascular flip are recommended techniques.