CLINICAL EXPERIENCE OF RETROGRADE REPLANTATION FOR AMPUTATED TOE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHENGHeyun ,  JUJihui , ZHAOQiang , SHIZhihua , LIXiangjun , HUMiao , DUWeiwei

Department of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215104, P. R. China;

Corresponding author：

JUJihui, Email: jjh2006@263.net

Keywords：

Toe; Isolated injury; Amputation replantation; Retrograde

DOI：

10.7507/1002-1892.20160112

Video：

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Objective To summarize the clinical experience of the retrograde replantation for amputated toe. Methods Between January 2010 and August 2015, 11 cases of amputated toes (15 toes) were treated by the retrograde replantation. All patients were male, with a mean age of 31 years (range, 18-45 years). The causes included cutting injury in 6 cases (9 toes) and crush injury in 5 cases (6 toes). One case had amputated great toe and distal segment of the second toe combined with the third toe nail bed contusion; 1 case had amputated proximal great toe and middle segment of the second and third toes; 1 case had amputated proximal segment of great toe and middle segment of the second toe; 7 cases had amputated distal segment of the great toe; and 1 case had amputated middle segment of the fifth toe. The time from injury to hospital was 1-3 hours (mean, 2 hours). Results Thirteen toes survived completely after operation. Toe necrosis occurred in 1 toe; partial dorsal skins necrosis and nail bed necrosis occurred in 1 toe, and was cure after repaired with dorsalis pedis island flap. The rate of success for replantation of amputated toes was 93.33% (14/15). X-ray examination showed fracture healing of all survival toes at 8-12 weeks after operation (mean, 10 weeks); internal fixation was removed. Eleven cases were followed up 3-12 months (mean, 7.5 months). The survival toes had good appearance and toenail. The two point discrimination was 9-12 mm (mean, 10 mm) at last follow-up. The patients could walk and run normally. Conclusion It is an ideal surgical method to use retrograde replantation to treat amputated toe, with the advantages of simple operation and high survival rate.

Citation： CHENGHeyun, JUJihui, ZHAOQiang, SHIZhihua, LIXiangjun, HUMiao, DUWeiwei. CLINICAL EXPERIENCE OF RETROGRADE REPLANTATION FOR AMPUTATED TOE. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(5): 555-557. doi: 10.7507/1002-1892.20160112 Copy

1.	谢昌平, 陈朝辉, 马运刚, 等. 改变体位提高断趾再植成功率的临床研究. 中华创伤骨科杂志, 2005, 7(4):338-340.
2.	田万成, 潘风雨, 卢全忠, 等. 逆行法断指再植临床应用体会. 中华显微外科杂志, 2008, 31(6):456-458.
3.	张贤龙, 刘兆青, 铁江辉. 经趾底足部不全离断逆行法再植术成功 1例. 实用手外科杂志, 2008, 22(4):231.
4.	李连楚. 特殊组织器官完全离断的显微再植. 实用手外科杂志, 2014, 28(3):294-297.
5.	陈德武, 郝鹏, 李苏皖, 等. 足趾及足断离再植63例. 中华显微外科杂志, 2000, 23(2):148-149.
6.	李连楚, 陈坚, 王增涛. 右足五趾完全离断再植成功一例. 中华显微外科杂志, 2008, 31(6):404.
7.	储国平, 吕国忠, 赵庆国, 等. 足拇趾离断再植及踝前穿支皮瓣修复成功一例. 中华整形外科杂志, 2011, 27(6):471-472.
8.	彭艳斌, 万圣祥, 肖颖锋, 等. 膝关节屈曲90°下肢平置顺行法再植拇趾. 临床和实验医学杂志, 2011, 10(3):184-185.
9.	曾明灿, 曹俊杰, 邱庆明, 等. 足趾离断再植17例. 中华显微外科杂志, 2003, 26(2):143-144.
10.	谢扬, 杨扬震, 吴道彬, 等. 足趾离断再植60例. 中华显微外科杂志, 2004, 27(2):111-112.
11.	韦酋亨. 足趾离断再植80例. 实用手外科杂志, 2007, 21(1):51-52.
12.	陈光, 施海峰, 芮永军, 等. 小儿足趾离断再植手术体会. 中国骨与关节损伤杂志, 2012, 27(10):953-954.
13.	李连楚, 周国伟, 李迎军, 等. 足趾多趾完全离断再植的临床体会. 中华显微外科杂志, 2010, 33(1):70-71.
14.	姜晓华, 杨天昀, 刘思法. 趾旋转撕脱性离断再植11例. 实用手外科杂志, 2010, 24(12):312-313.
15.	隋海明, 丛海波, 王晨霖, 等. 趾撕脱性离断再植. 中华显微外科杂志, 2003, 26(4):302-303.
16.	臧成五, 赵睿, 张航, 等. 不同术式在指尖再植中的临床应用. 中华手外科杂志, 2013, 29(3):185-186.
17.	潘维亮, 张峰, 徐传刚, 等. 顺行法和逆行法在含拇指或足趾断指 (趾)再植中的对比研究. 中国临床实用医学, 2010, 4(12):34-36.
18.	周明武, 李坤德, 赵东升, 等. 静脉动脉化在手指再植与再造中的应用. 中华手外科杂志, 2006, 22(2):101-102.

1. 谢昌平, 陈朝辉, 马运刚, 等. 改变体位提高断趾再植成功率的临床研究. 中华创伤骨科杂志, 2005, 7(4):338-340.
2. 田万成, 潘风雨, 卢全忠, 等. 逆行法断指再植临床应用体会. 中华显微外科杂志, 2008, 31(6):456-458.
3. 张贤龙, 刘兆青, 铁江辉. 经趾底足部不全离断逆行法再植术成功 1例. 实用手外科杂志, 2008, 22(4):231.
4. 李连楚. 特殊组织器官完全离断的显微再植. 实用手外科杂志, 2014, 28(3):294-297.
5. 陈德武, 郝鹏, 李苏皖, 等. 足趾及足断离再植63例. 中华显微外科杂志, 2000, 23(2):148-149.
6. 李连楚, 陈坚, 王增涛. 右足五趾完全离断再植成功一例. 中华显微外科杂志, 2008, 31(6):404.
7. 储国平, 吕国忠, 赵庆国, 等. 足拇趾离断再植及踝前穿支皮瓣修复成功一例. 中华整形外科杂志, 2011, 27(6):471-472.
8. 彭艳斌, 万圣祥, 肖颖锋, 等. 膝关节屈曲90°下肢平置顺行法再植拇趾. 临床和实验医学杂志, 2011, 10(3):184-185.
9. 曾明灿, 曹俊杰, 邱庆明, 等. 足趾离断再植17例. 中华显微外科杂志, 2003, 26(2):143-144.
10. 谢扬, 杨扬震, 吴道彬, 等. 足趾离断再植60例. 中华显微外科杂志, 2004, 27(2):111-112.
11. 韦酋亨. 足趾离断再植80例. 实用手外科杂志, 2007, 21(1):51-52.
12. 陈光, 施海峰, 芮永军, 等. 小儿足趾离断再植手术体会. 中国骨与关节损伤杂志, 2012, 27(10):953-954.
13. 李连楚, 周国伟, 李迎军, 等. 足趾多趾完全离断再植的临床体会. 中华显微外科杂志, 2010, 33(1):70-71.
14. 姜晓华, 杨天昀, 刘思法. 趾旋转撕脱性离断再植11例. 实用手外科杂志, 2010, 24(12):312-313.
15. 隋海明, 丛海波, 王晨霖, 等. 趾撕脱性离断再植. 中华显微外科杂志, 2003, 26(4):302-303.
16. 臧成五, 赵睿, 张航, 等. 不同术式在指尖再植中的临床应用. 中华手外科杂志, 2013, 29(3):185-186.
17. 潘维亮, 张峰, 徐传刚, 等. 顺行法和逆行法在含拇指或足趾断指 (趾)再植中的对比研究. 中国临床实用医学, 2010, 4(12):34-36.
18. 周明武, 李坤德, 赵东升, 等. 静脉动脉化在手指再植与再造中的应用. 中华手外科杂志, 2006, 22(2):101-102.

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Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL EXPERIENCE OF RETROGRADE REPLANTATION FOR AMPUTATED TOE

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