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find Keyword "指神经" 4 results
  • 指神经血管筋膜蒂逆行岛状皮瓣的临床应用

    Release date:2016-09-01 09:26 Export PDF Favorites Scan
  • Single-Injection Digital Block versus Traditional Digital Block for Local Anesthesia in Digital Injury Patients: A Randomized Controlled Trial

    Objective To compare the anesthetic effects of traditional digital block with single-injection digital block in digital injury patients for subcutaneous digital blocks. Methods Patients with one or two digits injured were randomized to the traditional digital block group and single-injection digital block group. All of the blocks were conducted by one investigator. The patients and outcome assessor were blinded to the treatment allocation. Both of the per-protocol-population (PP) analysis and the intention-to-treatment (ITT) analysis were performed to compare the two block techniques in terms of the pain during infiltration, the onset time of anesthesia and the failure rate of anesthesia. Results A total of 93 patients (109 digits) were included with 51 (61 digits) in the traditional block group and 42 (48 digits) in the single-injection block group.Two patients (3 digits) dropped out. Both of the PP analysis and ITT analysis showed that no significant difference between the two groups were detected in terms of the pain during infiltration, the onset time of anesthesia and the failure rate of anesthesia (P﹥0.05). Conclusions The subcutaneous single-injection digital block is as effective as the traditional digital block, but is much easier to perform. This technique is indicated for the digital anesthesia of palmar aspect distal to the proximal digital crease and dorsal aspect of the distal and middle phalanxes.

    Release date:2016-09-07 02:18 Export PDF Favorites Scan
  • 携带单侧指动脉及神经的长V-Y推进皮瓣修复指端缺损

    目的总结携带单侧指动脉及神经的长V-Y推进皮瓣修复指端缺损的疗效。 方法2012年3月-2015年11月,采用携带单侧指动脉及神经的长V-Y推进皮瓣修复指端皮肤软组织缺损26例(35指)。男17例(25指),女9例(10指);年龄1~70岁,平均39岁。致伤原因:压砸伤19例(28指),绞伤5例(5指),切割伤2例(2指)。受伤至入院时间90 min~9 h,平均4 h。损伤指别:拇指3指,示指9指,中指11指,环指10指,小指2指。软组织缺损范围0.8 cm×0.5 cm~2.5 cm×1.8 cm。均伴骨外露。 结果术后皮瓣均全部成活,切口均Ⅰ期愈合。23例(31指)获随访,随访时间6~32个月,平均13个月。皮瓣质地良好,患指指体匀称,指端饱满。末次随访时皮瓣两点辨别觉为2~6 mm,平均3.7 mm;按中华医学会手外科学会上肢部分功能评定试用标准评价:优29指,良2指,优良率为100%。 结论携带单侧指动脉及神经的长V-Y推进皮瓣修复指端缺损,手术操作简便,成功率高,术后手指外观及功能恢复理想。

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  • Clinical application of neurovascular staghorn flap for repairing of defects in fingertips

    Objective To evaluate the effectiveness of neurovascular staghorn flap for repairing defects in fingertips. Methods Between August 2019 and October 2021, a total of 15 fingertips defects were repaired with neurovascular staghorn flap. There were 8 males and 7 females with an average age of 44 years (range, 28-65 years). The causes of injury included 8 cases of machine crush injury, 4 cases of heavy object crush injury, and 3 cases of cutting injury. There were 1 case of thumb, 5 cases of index finger, 6 cases of middle finger, 2 cases of ring finger, and 1 case of little finger. There were 12 cases in emergency, and 3 cases with finger tip necrosis after trauma suture. Bone and tendon exposed in all cases. The range of fingertip defect was 1.2 cm×0.8 cm to 1.8 cm×1.5 cm, and the range of skin flap was 2.0 cm×1.5 cm to 2.5 cm×2.0 cm. The donor site was sutured directly. Results All flaps survived without infection or necrosis, and the incisions healed by first intention. All patients were followed up 6-12 months, with an average of 10 months. At last follow-up, the appearance of the flap was satisfactory, the wear resistance was good, the color was similar to the skin of the finger pulp, and there was no swelling; the two-point discrimination of the flap was 3-5 mm. One patient had linear scar contracture on the palmar side with slight limitation of flexion and extension, which had little effect on the function; the other patients had no obvious scar contracture, good flexion and extension of the fingers, and no dysfunction. The finger function was evaluated according to the total range of motion (TAM) system of the Hand Surgery Society of Chinese Medical Association, and excellent results were obtained in 13 cases and good results in 2 cases. Conclusion The neurovascular staghorn flap is a simple and reliable method to repair fingertip defect. The flap has a good fit with the wound without wasting skin. The appearance and function of the finger are satisfactory after operation.

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