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find Keyword "手外科" 3 results
  • APPLICATION OF THE MINOR UNILATERAL MULTIFUNCTIONAL EXTERNAL FIXATOR IN HAND SURGER

    A series of 28 cases of fractures of the small tubular bones of the hand, including Bennetts fracture, were treated with the minor unilateral multifunctional external fixator. After manipulation, a hole was drilled on the proximal and distal parts of the fractured bone. Hand in functional position, the external fixator was set in place. Functional exercises were begun after the fixation. The patients were follwed up for two to six months. The average healing time was thirtyfive days. The average healing time for Bennett’s fractures was twentyeight days, and for the fractures of metacarpal bone was forty-two days. There were no deformity and complication of infection following external fixation.The functional recovery of the hands was satisfactory. The fixator had the following advantages: It was simple and had tight fixation; fractures with infection, was still indicated and could be adjusted according to the clinical purpose.

    Release date:2016-09-01 11:16 Export PDF Favorites Scan
  • 四种前臂逆行岛状皮瓣在手外科的应用

    自1987年以来,采用四种不同血管蒂的前臂逆行岛状皮瓣修复手部各种创面共45例,其中以桡动脉为蒂的14例,尺动脉为蒂的6例,骨间背侧动脉为蒂的16例,尺动脉腕上皮支为蒂的9例。除1例失败外均全部成活。修复效果满意。此四种前臂岛状皮瓣在手外科修复术中各有其临床应用价值。对这四种前臂岛状皮瓣的解剖特点,切取后对手部血供的影响以及手术适应证进行了讨论。

    Release date:2016-09-01 11:14 Export PDF Favorites Scan
  • 完全清醒无止血带局部麻醉技术在手外科手术中的应用

    目的总结完全清醒无止血带局部麻醉技术(wide awake local anesthesia no tourniquet,WALANT)在手外科手术中的应用效果。方法 2021年4月—10月,采用WALANT为28例手外伤患者实施麻醉并手术。男18例,女10例,年龄15~55岁,平均35岁。急诊手术22例,择期手术6例。骨折切开复位内固定术5例,骨折内固定物取出术l例,肌腱探查断裂修复术18例,肌腱粘连松解术4例。采用疼痛视觉模拟评分(VAS)评估疼痛情况,术中观察出血情况,术后观察麻醉维持时间、手指血供变化及有无并发症发生,采用主动运动总和法(TAM)评定手部功能。结果 术中麻醉与止血效果满意,患者未诉疼痛。第1针刺入皮肤时VAS评分为2~4分;术中操作未引起明显疼痛,VAS评分为0~1分;麻醉效果可持续6~8 h,VAS评分为2~6分。术后手术区域麻醉效果逐渐消失后,所有患者口服或静脉滴注非甾体止痛药能有效缓解疼痛。术后24 h内患者无头痛、头晕、恶心、呕吐、乏力、皮疹等药物不良反应,术后8 h手指皮温及毛细血管反应同正常手指。术后未出现血运障碍等麻醉不良反应。28例患者均获随访,随访时间6~12个月,平均8个月。末次随访时TAM评定获优20例、良8例。结论手外科手术中应用WALANT止痛和止血效果良好、操作简单、安全有效,术中能即刻观察手术效果。

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