CAJ | 학술논문

目的:探讨去表皮包埋甲根部以远的离断再植方法.方法:本院2011年-2012年甲根部以远完全离断指20指,彻底清创后,显微镜下探查血管,失去吻合再植,行骨折内固定、神经吻合、离断指原位缝合,去表皮后将指包埋于鱼际或者腹部处,常规防感染等治疗,3周后局部浸润麻醉下取出,局部保持湿润、促进上皮化.结果:16指存活,外形良好,随访6~12个月,手指屈伸正常,外形良好,其中2指指体细小、惧冷,两点辨别觉2~7 mm.其余4指取出后有2指完全坏死,2指指端坏死,给予残端修整治疗.结论:甲根部以远的离断,去表皮包埋治疗,在失去血管吻合条件下是一种理想的治疗方案.
목적:탐토거표피포매갑근부이원적리단재식방법.방법:본원2011년-2012년갑근부이원완전리단지20지,철저청창후,현미경하탐사혈관,실거문합재식,행골절내고정、신경문합、리단지원위봉합,거표피후장지포매우어제혹자복부처,상규방감염등치료,3주후국부침윤마취하취출,국부보지습윤、촉진상피화.결과:16지존활,외형량호,수방6~12개월,수지굴신정상,외형량호,기중2지지체세소、구랭,량점변별각2~7 mm.기여4지취출후유2지완전배사,2지지단배사,급여잔단수정치료.결론:갑근부이원적리단,거표피포매치료,재실거혈관문합조건하시일충이상적치료방안.
Objective:To discuss a replantation method for beyond fingernail root amputation with embedding to subcutaneous pocket. Methods:From 2011 to 2012,the embedding method was applied to 20 beyond fingernail root amputations in 20 patients. After debidement of amputated finger,we had not found anastomosis vessel of amputated fingers through microscope. Fractured bone segment fixed with one kirschner wire,connected the nervus,stutured the amputated fingers to normal position and de-epithelialized amputated part to skin dermis,the reattached parts were inserted into the subcutaneous pocket of ipsilateral palm or abdominal. After three weeks,the reattached fingers were removed from the subcutaneous pocket. Result:Sixteen fingers had recovered completely. Six months to one year later,the replanted 14 fingers had satisfactory sensation(discrimination 2-7 mm),appearance and perfect function. 2 fingers were lessen and sensation of chill. There were necrosis happened in another 2 fingers,and the other 2 fingertips.Conclusion:The method of embedding to subcutaneous pocket is a effective treatment for beyond fingernail root amputation,which loses vascular anastomo-sis conditions.