CAJ | 학술논문

目的探讨利用虎口动脉和示指尺侧指固有动脉转位治疗拇指旋转撕脱离断的临床疗效差异. 方法 2011年1月至2012年5月,对16例拇指旋转撕脱离断患者分别采用虎口动脉转位(A组,8例)和示指尺侧指固有动脉转位(B组,8例)重建离断拇指动脉供血.A组:男6例,女2例；年龄(27.0±9.5)岁.致伤原因:机器绞伤7例,车祸伤1例.受伤至手术时间为(6.1±3.1)h.离断平面:近节指骨基底部5例,掌指关节平面3例.B组:男5例,女3例；年龄(29.7±13.7)岁.致伤原因:机器绞伤6例,绳索绞伤2例.离断平面:受伤至手术时间为(7.1±2.2)h.近节指骨基底部4例,掌指关节平面4例；静脉、神经、肌腱修复按照常规进行. 结果 A组、B组共16例断指全部成活.A、B组手术时间分别为(3.2±0.8)h及(5.3±0.6)h,差异有统计学意义(P＜0.05).所有患者均获随访,随访时间3～ 10个月(平均6.9个月).按中华医学会手外科学会断指再植功能评定使用标准,A、B组优良率均为75.0％,差异无统计学意义(P＞0.05). 结论利用虎口动脉和示指尺侧指固有动脉转位治疗拇指旋转撕脱两种方法疗效相近,但前者操作更简便,创伤更小,是一种较好的再植方法.
목적 탐토이용호구동맥화시지척측지고유동맥전위치료무지선전시탈리단적림상료효차이. 방법 2011년1월지2012년5월,대16례무지선전시탈리단환자분별채용호구동맥전위(A조,8례)화시지척측지고유동맥전위(B조,8례)중건리단무지동맥공혈.A조:남6례,녀2례；년령(27.0±9.5)세.치상원인:궤기교상7례,차화상1례.수상지수술시간위(6.1±3.1)h.리단평면:근절지골기저부5례,장지관절평면3례.B조:남5례,녀3례；년령(29.7±13.7)세.치상원인:궤기교상6례,승색교상2례.리단평면:수상지수술시간위(7.1±2.2)h.근절지골기저부4례,장지관절평면4례；정맥、신경、기건수복안조상규진행. 결과 A조、B조공16례단지전부성활.A、B조수술시간분별위(3.2±0.8)h급(5.3±0.6)h,차이유통계학의의(P＜0.05).소유환자균획수방,수방시간3～ 10개월(평균6.9개월).안중화의학회수외과학회단지재식공능평정사용표준,A、B조우량솔균위75.0％,차이무통계학의의(P＞0.05). 결론 이용호구동맥화시지척측지고유동맥전위치료무지선전시탈량충방법료효상근,단전자조작경간편,창상경소,시일충교호적재식방법.
Objective To compare the clinical outcomes of using the Hukou artery and ulnar proper digital artery of index finger translocation to reconstruct artery supply in replanting of rotated and avulsed thumb.Methods From January 2011 to May 2012,replantation surgery were carried out in 16 patients with rotated and avulsed injury of thumb.In group A,all cases were replanted by Hukou artery translocation,in which 6 males and 2 females and (27.0 ±9.5) years old in average.The causes of injury were machine strangulation (7 patients) and traffic accident (1 patient).The average time from injury to operation were(6.1 ± 3.1) hours.The amputed level were at the base of proximal phalanx (5 patients) and metacarpophalangeal joint (3 patients).In group B,all patients were replanted using ulnar proper digital artery of index finger translocation,in which 5 males and 3females and (29.7 ± 13.7) years old in average.The causes of injury were machine strangulation (6 patients) and cord wring injury (2 patient).The average time from injury to operation were(7.1 ±2.2) hours.The amputed level were at the base of proximal phalanx (4 patients) and metacarpophalangeal joint (4 patients).Results The operation time were (3.2 ± 0.8) minutes in group A and (5.3 ± 0.6) minutes in group B.All fingers were survived in both groups.All patients were followed up 3-10 months (6.9 months on average).Excellent rate reached 75.0％ in group A and 75.0％ in group B according to Criterion on Functional evaluation on Finger Reconstruction issued by Chinese society of hand surgery.There were significant differences between the two groups in operation time (P ＜ 0.05),and without differences in excellent rate (P ＞ 0.05).Conclusion There are same outcome by using the Hukou artery and ulnar proper digital artery of index finger to reconstruct artery supply in replantation of rotated and avulsed thumb.However,using the Hukou artery translocation were more simple and minimally invasive.