Effectiveness of combined tissue transplantation to repair serially damaged injuries on radial side of hand_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MI Shouhu ,  TENG Yunsheng , LIANG Gaofeng , DUAN Chaopeng , ZHANG Manying , JIA Zonghai , ZHANG Wei , WANG Zenghui , WEN Bo , DONG Junwen , GUO Yongming

Department of Hand Microsurgery, 521 Hospital of Norinco Group, Xi’an Shaanxi, 710065, P.R.China;

Corresponding author：

TENG Yunsheng, Email: 1156982650@qq.com

Keywords：

Hand; damaged injury; tissue flap; combined transplantation; wound repair; functional reconstruction

DOI：

10.7507/1002-1892.202012068

Video：

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Objective To investigate the effectiveness of combined tissue transplantation for repair of serially damaged injuries on radial side of hand and function reconstruction. Methods Between May 2013 and May 2017, 34 cases of serially damaged injuries on radial side of hand were treated. There were 29 males and 5 females; aged 17-54 years, with an average of 32.1 years. There were 23 cases of crushing injuries, 5 cases of bruising injuries, 4 cases of machine strangulation injuries, and 2 cases of explosion injuries. The time from injury to admission was 40 minutes to 3 days, with an average of 10 hours. According to the self-determined serially damaged injuries classification standard, there were 1 case of typeⅠa, 2 cases of typeⅠb, 10 cases of typeⅡa, 5 cases of type Ⅱb, 3 cases of type Ⅱc, 1 case of type Ⅱd, 7 cases of type Ⅲa, 3 cases of type Ⅲb, 1 case of type Ⅲc, and 1 case of type Ⅲd. According to the classification results, the discarded finger, nail flap, the second toe, anterolateral thigh flap, ilium flap, fibula flap, and other tissue flaps were selected to repair hand wounds and reconstruct thumb, metacarpal bones, and fingers. Results After operation, 2 cases of flaps developed vascular crisis and survived after symptomatic treatment; the other transplanted tissue survived smoothly. All cases were followed up 1 to 7 years, with an average of 2.4 years. The average fracture healing time was 7.4 weeks (range, 5.3-9.0 weeks). At last follow-up, the reconstructed fingers and the grafted flaps recovered good sensory function, with a two-point discrimination of 5 to 11 mm (mean, 9 mm). According to the evaluation standard of the upper limb function evaluation of the Chinese Medical Association Hand Surgery Society, the reconstructed thumb was rated as excellent in 24 thumbs, good in 8 thumbs, and fair in 2 thumbs; the reconstructed finger was rated as excellent in 18 fingers, good in 2 fingers, and fair in 1 finger. Conclusion For the serially damaged injuries on radial side of hand, according to its classification, different tissues are selected for combined transplantation repair and functional reconstruction, which can restore hand function to the greatest extent and improve the quality of life of patients.

Citation： MI Shouhu, TENG Yunsheng, LIANG Gaofeng, DUAN Chaopeng, ZHANG Manying, JIA Zonghai, ZHANG Wei, WANG Zenghui, WEN Bo, DONG Junwen, GUO Yongming. Effectiveness of combined tissue transplantation to repair serially damaged injuries on radial side of hand. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(5): 601-604. doi: 10.7507/1002-1892.202012068 Copy

1.	莫勇军, 程志琳, 许林, 等. 3D 打印技术辅助修复手桡侧严重毁损伤九例. 中华显微外科杂志, 2018, 41(4): 334-338.
2.	吴学仁, 魏盼杰, 赵耀华, 等. 髂腹股沟复合组织瓣修复手足部皮肤软组织缺损的效果. 中华烧伤杂志, 2020, 36(8): 722-725.
3.	王云锋, 沈昊, 杨敏, 等. 取掌长肌移植联合多种皮瓣修复多指复合组织缺损. 中华手外科杂志, 2020, 36(3): 236-238.
4.	詹宏钢, 汤样华, 徐灿达, 等. 复合组织瓣移植修复伴有伸肌腱缺损的指背软组织缺损创面. 中华手外科杂志, 2020, 36(3): 238-240.
5.	谢庆平, 徐润龙, 石仕元, 等. 组合组织移植在修复手毁损伤中的应用. 中华手外科杂志, 2001, 17(3): 148-150.
6.	余志平, 于晓峰, 丛海波, 等. 复杂拇指缺损合并桡侧大面积皮肤缺损的重建与修复. 实用手外科杂志, 2017, 31(2): 233-235.
7.	金光哲, 王凯, 熊胜, 等. 伴有虎口区皮肤缺损的拇指缺损再造. 中华手外科杂志, 2016, 32(5): 334-335.
8.	潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3): 130-135.
9.	廖坚文, 张振伟, 庄加川, 等. 手桡侧毁损伤分型初步探讨. 中华手外科杂志, 2010, 26(4): 216-218.
10.	滕云升, 郭永明, 智丰, 等. 组织联合移植修复手部毁损伤的临床应用. 中华手外科杂志, 2013, 29(2): 92-94.
11.	Jorm L. Firework injuries in New South Wales, 1992-93 to 2001-02. N S W Public Health Bull, 2003, 14(6): 110-113.
12.	Vassilia K, Eleni P, Dimitrios T. Firework-related childhood injuries in Greece: a national problem. Burns, 2004, 30(2): 151-153.
13.	程国良. 不同形式的足趾移植拇手指再造与修复. 中华显微外科杂志, 2002, 25(1): 8-9.
14.	李兵, 俞光荣, 杨云峰, 等. 两种第二趾切取游离移植对供足足底应力影响的生物力学研究. 中华创伤骨科杂志, 2010, 12(9): 869-872.
15.	林立, 颜磊, 叶润棠, 等. 腓骨皮瓣移植重建第 1 跖骨及第 2 跖骨头复合组织缺损一例. 中华显微外科杂志, 2019, 42(5): 515-516.
16.	Taccardo G, DE Vitis R, Parrone G, et al. Surgical treatment of trapeziometacarpal joint osteoarthritis. Joints, 2014, 1(3): 138-144.
17.	梁高峰, 智丰, 滕云升, 等. 游离股前外侧肌皮瓣加植皮修复手掌背软组织缺损. 中华手外科杂志, 2015, 31(4): 320.
18.	郭洪娟, 邓高丽, 冯璐, 等. 医护一体化护理模式在手部毁损伤病人术后功能康复中的应用. 护理研究, 2017, 31(18): 2254-2256.

1. 莫勇军, 程志琳, 许林, 等. 3D 打印技术辅助修复手桡侧严重毁损伤九例. 中华显微外科杂志, 2018, 41(4): 334-338.
2. 吴学仁, 魏盼杰, 赵耀华, 等. 髂腹股沟复合组织瓣修复手足部皮肤软组织缺损的效果. 中华烧伤杂志, 2020, 36(8): 722-725.
3. 王云锋, 沈昊, 杨敏, 等. 取掌长肌移植联合多种皮瓣修复多指复合组织缺损. 中华手外科杂志, 2020, 36(3): 236-238.
4. 詹宏钢, 汤样华, 徐灿达, 等. 复合组织瓣移植修复伴有伸肌腱缺损的指背软组织缺损创面. 中华手外科杂志, 2020, 36(3): 238-240.
5. 谢庆平, 徐润龙, 石仕元, 等. 组合组织移植在修复手毁损伤中的应用. 中华手外科杂志, 2001, 17(3): 148-150.
6. 余志平, 于晓峰, 丛海波, 等. 复杂拇指缺损合并桡侧大面积皮肤缺损的重建与修复. 实用手外科杂志, 2017, 31(2): 233-235.
7. 金光哲, 王凯, 熊胜, 等. 伴有虎口区皮肤缺损的拇指缺损再造. 中华手外科杂志, 2016, 32(5): 334-335.
8. 潘达德, 顾玉东, 侍德, 等. 中华医学会手外科学会上肢部分功能评定试用标准. 中华手外科杂志, 2000, 16(3): 130-135.
9. 廖坚文, 张振伟, 庄加川, 等. 手桡侧毁损伤分型初步探讨. 中华手外科杂志, 2010, 26(4): 216-218.
10. 滕云升, 郭永明, 智丰, 等. 组织联合移植修复手部毁损伤的临床应用. 中华手外科杂志, 2013, 29(2): 92-94.
11. Jorm L. Firework injuries in New South Wales, 1992-93 to 2001-02. N S W Public Health Bull, 2003, 14(6): 110-113.
12. Vassilia K, Eleni P, Dimitrios T. Firework-related childhood injuries in Greece: a national problem. Burns, 2004, 30(2): 151-153.
13. 程国良. 不同形式的足趾移植拇手指再造与修复. 中华显微外科杂志, 2002, 25(1): 8-9.
14. 李兵, 俞光荣, 杨云峰, 等. 两种第二趾切取游离移植对供足足底应力影响的生物力学研究. 中华创伤骨科杂志, 2010, 12(9): 869-872.
15. 林立, 颜磊, 叶润棠, 等. 腓骨皮瓣移植重建第 1 跖骨及第 2 跖骨头复合组织缺损一例. 中华显微外科杂志, 2019, 42(5): 515-516.
16. Taccardo G, DE Vitis R, Parrone G, et al. Surgical treatment of trapeziometacarpal joint osteoarthritis. Joints, 2014, 1(3): 138-144.
17. 梁高峰, 智丰, 滕云升, 等. 游离股前外侧肌皮瓣加植皮修复手掌背软组织缺损. 中华手外科杂志, 2015, 31(4): 320.
18. 郭洪娟, 邓高丽, 冯璐, 等. 医护一体化护理模式在手部毁损伤病人术后功能康复中的应用. 护理研究, 2017, 31(18): 2254-2256.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of combined tissue transplantation to repair serially damaged injuries on radial side of hand

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