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1、臨床骨科雜志Journa2ofClinicalOrthopaedics2014Apr;17(2)doi:10.3969/j.issn.1008-0287.2014.02.037·臨床論著·原位回植加壓包扎治療37例指尖離斷傷黃益楚,章偉祥,陳孝軍,都巍摘要:目的探討指尖離斷傷治療方法和療效。方法手術(shù)治療指尖平面完全離斷伴有指骨、甲床損傷而無(wú)法再植的37例患者(39指),創(chuàng)面面積:0.3amx1.2am一0.5emx1.8cm。常規(guī)清創(chuàng)后,將離體指與近端斷面解剖復(fù)位,用5-0絲線間斷縫合,加壓包扎固定;術(shù)后12d拆除加壓包堆,3周拆線。結(jié)果成活34指,成活率87.2%。33例獲得隨訪,時(shí)間3
2、~24個(gè)月,傷指外形、顏色與健側(cè)基本無(wú)異,指甲生長(zhǎng)完好,局部無(wú)觸、壓痛,痛溫覺(jué)及精細(xì)感覺(jué)基本恢復(fù)正常。結(jié)論應(yīng)用原位縫合打包加壓包扎修復(fù)指尖離斷無(wú)法再植的手指,可以保留最佳的外觀和功能。關(guān)鍵詞:指尖損傷;原位縫合術(shù);加壓包扎;斷指再植中圖分類號(hào):R658.1;R683.41;R687.2;R687.3文獻(xiàn)標(biāo)識(shí)碼:A文章編號(hào):1008—0287(2014)02—0204—03Replantationinsitucompressionbandagingintreatmentof37casesoffingertipamputationHUANGYi—chu,ZHANGWei—xiang,CHENX
3、iaojun,DUWei(DeptofHandSurgery,theTCMandWesternMedicineHospitalofNanxunDistrict,Huzhou,Zhejiang313009,China)Abstract:0bjectiveTodiscussthetreatmentsandeffectsoffingertipamputation.MethodsTherewere37pa—tients(39fingers)whosefingerplaneswerecompletelydisconnectedwithphalangesandnailbedsinjured,while
4、theinjuredfingerscouldnotbereplanted.Thewoundareawas:0.3cmX1.2cm一0.5cm×1.8cm.Afterroutinede—bridement,theseveredfingerswererepairedbyconnectingseveredfingerswiththeproximalsections;interruptedSU—tureswereusedintheskinswithsilksutures(543);theseveredfingerswerecompressedandfixedwithgauzes;compressi
5、onbagswereremoved12daysaftertheoperationsandthesutureswereremovedthreeweekslater.Results34fingerssurvived(thesurvivalrate,87.2%).33patientswerefollowedupfor3~24months.Thecolorofre—plantedfingerswascomparabletothatofthehealthysidewithsatisfactoryappearance.Nailsgrewwellwithouttender—ness.Thepain,te
6、mperatureandepicriticsensibilitybasicallyrecoveredtonorma1.ConclusionsThroughapplica—tionofinsitusutureandcompressionbandagetorepairfingertipamputation,fingertipswhichcannotbereplantedcanmaintainbestappearancesandfunctionsKeywords:fingertipinjuries;situsutures;compressionbandages;severedfingersrep
7、lantation指尖是指甲根部以遠(yuǎn)的部分,它不僅要完成抓、創(chuàng)面面積:0.3cm×1.2am~0.5cmX1.8am。受捏、握動(dòng)作,而且含有豐富的感覺(jué)神經(jīng)末梢。指尖完傷距手術(shù)時(shí)間為1~4h。全離斷是手部較常見(jiàn)創(chuàng)傷之一。2009年7月~1.2手術(shù)方法指根神經(jīng)阻滯麻醉。指根部扎橡2012年11月,我們應(yīng)用原位縫合打包加壓包扎治皮條止血帶。常規(guī)予雙氧水以及溫?zé)o菌生理鹽水療37例指尖離斷傷患者,療效顯著,報(bào)道如下。(30~40~