拇指再植与血运重建术在肌肉骨骼创伤中心的应用——附2例报告

Grzegorz Szczesny, Maciej Bazała
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引用次数: 0

摘要

本文报告2例在骨科手术成功的青年男性主肢拇指显微外科再植及血运重建术,这些患者无法在专科再植中心进行手术治疗。手术显微镜下显微手术吻合手指动静脉,修复手指微血管,用克氏针髓内固定骨折。在这两种情况下,手指的活力都得到了恢复,这使得软组织和骨骼得到了适当的愈合,从而恢复了拇指的令人满意的功能。由于其对手部功能的重要性,拇指损伤伴其丧失应优先处理。由于血管直径小,这些手术需要特殊的仪器和训练有素的人员,因此应该在再植中心进行。然而,当无法在合适的中心进行治疗时,这些手术也可以由训练有素的骨科医生成功完成。
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[Replantation and revascularization of the thumb in musculoskeletal trauma center--presentation of 2 cases].

Summary We present two cases of successful microsurgical replantation and revascularization of the thumb of dominating extremity in young men performed in orthopedic department, to whom operative treatment in specialized replantation center could not be performed. Microvasculature of the finger was restored anastomosing microsurgically its artery and vein under operative microscope, and bone fracture was stabilized intramedullary with Kirschner wires. In both cases vitality of the finger was restored, which enabled proper healing of soft tissues and bone, leading to restoration of satisfactory function of the thumb. Due to high value for the function of the hand, thumb injuries threading with its loss should be managed primarily. Due to small vessel diameter those procedures require special instrumentation and trained personnel, and thus shouldbe done in replantation centers. Nevertheless, when treatment in an appropriate center is unavailable, those procedures could also be successfully performed by trained orthopedists.

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