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find Author "杨红海" 2 results
  • TEMPORARY ECTOPIC IMPLANTATION OF AMPUTATED FINGERS AND DORSALIS PEDIS FLAPS FOR THUMB RECONSTRUCTION AND SKIN DEFECT REPAIR OF HANDS

    Objective To investigate the feasibility of temporary ectopic implantation of amputated fingers and dorsalis pedis flaps for thumb reconstruction and skin defect repair of the hand. Methods Between February 2006 and February 2012, 9 patients with thumb amputation having no replanted condition were treated. There were 7 males and 2 females with an average age of 35 years (range, 20-45 years). The injury causes included explosive injury in 1 case, puncher injury in 1 case, stiring machine injury in 1 case, gear injury in 3 cases, and heavy pound injury in 3 cases. At 2-5 hours after injury, one-stage temporary ectopic implantation of amputated finger to foot was performed. After debridement, thumb defect was rated as degree III in 1 case, as degree IV in 3 cases, and as degree V in 5 cases. When amputated fingers survived completely after 1-4 months, the amputated finger was replanted to its anatomic position, skin defect was repaired with dorsalis pedis flap. The area of skin defect ranged from 5 cm × 4 cm to 7 cm × 6 cm. The area of flaps ranged from 6 cm × 5 cm to 8 cm × 7 cm. The donor site was repaired by the skin grafting. Results Arterial crisis occurred in 1 case after 1 day of one-stage operation, and was cured after vascular exploration, and the amputated fingers survived in the others. The reconstructed thumbs and flaps survived after two-stage operation, and the skin graft at donor site survived. The patients were followed up 1-4 years (mean, 2.8 years). The reconstructed thumbs had good appearance and satisfactory opposition and finger-to-finger functions. According to the standard functional evaluation issued by Hand Surgery Association of Chinese Medical Association, the scores of survival fingers were 73-91 (mean, 84); the results were excellent in 7 cases and good in 2 cases with an excellent and good rate of 100%. Conclusion Temporary ectopic implantation of amputated finger to foot combined with dorsalis pedis flap can be used to reconstruct thumb and repair skin defect of the hand.

    Release date:2016-08-31 04:12 Export PDF Favorites Scan
  • 废弃手指远位寄养二期回植再造手

    目的 总结废弃手指远位寄养二期回植再造手、重建手功能的方法。 方法 2005 年2 月- 2008 年12 月,将5 例远断端完整而近断端毁损无法一期再植的废弃拇指远位寄养,将拇指一侧指固有动脉与健侧腕部尺动脉腕上皮支下行支或足背跗外侧动脉吻合,并吻合2 条浅静脉,成活后1.5 ~ 3.0 个月将拇指二期回植于手部再造手。男3 例,女2 例;年龄7 ~ 43 岁。受伤至就诊时间1 ~ 3 h,拇指缺血时间3 ~ 6 h。 结果 5 例均获随访,随访时间11 个月~ 4 年。废弃手指远位寄养回植再造手均成活,回植拇指外观饱满,色泽红润。两点辨别觉8 ~ 10 mm。2 例行拇对掌功能重建术者恢复对掌功能;3 例未行拇对掌功能重建术者中1 例恢复部分对掌功能,2 例无对掌功能。手部功能依据中华医学会手外科学会拇、手指再造功能评定试用标准评分为7 ~ 13 分,平均9.2 分;其中优1 例,良4 例。 结论 废弃指远位寄养二期回植再造手是一种可行且有效的手术方法。

    Release date:2016-08-31 05:49 Export PDF Favorites Scan
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