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find Keyword "再植术" 17 results
  • 双下肢离断毁损伤前足移位再植一例五年随访报告

    目的报告1例采用离断的右足移位再植修复毁损左足的临床效果。 方法2007年5月收治1 例火车碾压致右踝及左前足离断的患者,伤后8 h入院。急诊手术将右小腿截肢,右足移位再植于左足。采用封闭式负压引流技术治疗未闭合创面,二期行游离植皮术。术后6个月右下肢安装义肢。 结果患者移位再植的左前足成活,植皮区成活。术后5年随访,生活已同常人,可完全自理;左足第4、5趾感觉良好,两点辨别觉约10 mm,第1、2、3趾感觉较差;踝关节活动度正常;按Sanders等提出的Maryland足功能评分标准评分为94分,达优。 结论双下肢离断毁损伤移位再植术可保全患者一侧肢体,并能获得良好功能。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 指侧方静脉在指尖离断再植中的应用

    目的 介绍吻合指尖区侧方静脉重建回流行指尖离断再植的方法。 方法2009年3月-2011年12月,收治36例(42指)指尖离断患者。男20例(24指),女16例(18指);年龄15~40岁,平均24.5岁。受伤原因:绞轧伤4例(4指),压砸伤6例(7指),电锯伤8例(8指),切割伤18例(23指)。离断指别:拇指3指,示指10指,中指15指,环指10指,小指4指。指尖分型:Ⅰ型19指,Ⅱ型5指,Ⅲ型11指,Ⅴ型7指。受伤至手术时间90 min~6 h,平均3.6 h。再植术中采用吻合侧方静脉重建回流,共吻合指侧方静脉80条,吻合动脉53条。 结果再植指尖均成活,无回流障碍发生,切口均Ⅰ期愈合。患者均获随访,随访时间6~24个月,平均14.5个月。指尖外形、功能恢复满意,指体无明显萎缩,39指指甲生长接近平整,3指指甲呈脊样生长。术后6个月根据1975年美国手外科学会推荐的手指总主动活动度(TAM)系统评定方法评定:优39指,良3指,优良率100%。 结论指尖离断再植中通过吻合侧方静脉可有效重建静脉回流。

    Release date:2016-08-31 04:06 Export PDF Favorites Scan
  • 不同程度耳廓撕脱伤的修复

    目的 总结不同程度耳廓撕脱伤修复方法的选择及疗效。 方法2005 年8月-2010年12月,收治26例耳廓撕脱伤患者。男10例,女16例;年龄5~63岁,平均27.5岁。致伤原因:机器绞伤9例,交通事故伤5例,暴力撕脱伤6例,动物咬伤6例。损伤部位:全耳廓撕脱6例,耳廓上1/3~2/3撕脱8例,耳廓外1/5~2/3撕脱6例,耳垂撕脱6例。受伤至手术时间1~12 h,平均4.5 h。直接清创原位缝合8例,血管吻合再植7例,一期清创、二期皮瓣再造5例,残端修整缝合6例。 结果术后6例残端修整缝合切口均Ⅰ期愈合;其余患者中耳廓完全成活14例,部分成活3 例,坏死3例。26例均获随访,随访时间6~24个月,平均16个月。直接清创原位缝合及血管吻合再植成活者耳廓外观优于其余方法。患者听力均正常。 结论对于全耳廓撕脱伤应首选血管吻合再植修复,对于耳廓撕脱组织小且无可供吻合血管者可选择原位直接缝合。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • CLINICAL STUDY OF PHALANGE FRACTURES TREATED BY ABSORBABLE INTRAMEDULLARY NAIL IN REPLANTATION OF SEVERED FINGER

    Objective To study the effect of internal fixation with absorbable intramedullary nail on the treatment of phalange fractures in replantation of severed finger. Methods From September 2001 to October 2003, 28 cases with industrial severed finger (21 males and 7 females, with the age of 18-35 years) were replanted within 1-6 hours. The severed locations were index fingers in 11 cases, middle fingers in 8 cases, ring fingers in 6 cases, little fingers in 3 cases. All cases of phalange fractures were fixed by absorbable intramedullary nails of poly-DL-lactic acid(PDLLA) that combined with chitosan. Out of the 28 cases, 15 cases were with proximal phalange, 11 cases were with middle phalange, 2 cases were with distal phalange. The bone marrow cavity of the phalanges were dilated, then the intramedullary nail was inserted with suitable diameter and length to fix the fracture. Postoperatively resin bandage was applied for 3-4 weeks.Results All the 28 patients survived the performance and postoperative follow-up ranged from 3 to 10 months(4 months in average). Rejection was observed in one case 3 weeks after operation, bone unions were obtained in other cases. According to the Chinese Medical Association’s evaluation standard for replantation of amputated finger, 18 fingers resulted in excellence, 9 fingers in good function and 1 with unsatisfactory function. The excellent and good rate was 96.4%. Conclusion Internal fixation with absorbable intramedullary nail of PDLLA combined with chitosan proves to be effective in the replantation of severed finger.

    Release date:2016-09-01 09:29 Export PDF Favorites Scan
  • 指尖离断再植12例

    Release date:2016-09-01 09:33 Export PDF Favorites Scan
  • TEMPORARY ECTOPIC IMPLANTATION OF AMPUTATED FOOT

    OBJECTIVE: To investigate an effective technique of temporary ectopic implantation for amputated extremity under complex condition. METHODS: Two cases of amputated foot, which could not be implanted primarily, were treated with temporary ectopic implantation. The other leg of patient was chosen as recipient site. The posterotibial artery and saphenous vein were chosen as recipient vessels. When the general condition and the proximal condition of the amputated part were suitable, the ectopic implanted feet were transferred to their anatomic positions. RESULTS: All the feet survived after the replantation. The injured limbs recovered their normal length and sensation. The patients could walk after 4-6 months. CONCLUSION: Temporary ectopic implantation is an ideal technique for the salvage of amputated limb and organ under special condition. Severed foot and lower segment of the leg under complex condition were the best indication for the temporary ectopic implantation.

    Release date:2016-09-01 09:35 Export PDF Favorites Scan
  • THE PATHOGENIC MECHANISM AND PREVENTION AND TREATMENT OF MUSCLE CONTRACTURE AFTER REPLANTATION OF SEVERED PALM OR WRIST

    OBJECTIVE To explore the pathogenic mechanism of intrinsic muscle contracture after replantation of severed palm or wrist, and put forward the prevention and treatment methods. METHODS From 1985 to 1997, 48 cases were received replantation of severed palm or wrist, among them, 9 cases with thumb adductor contracture and 6 cases with intrinsic muscle contracture were occurred in different degree. Two cases with mild thumb adductor contracture were received conservative treatment, and 7 cases with moderate thumb adductor contracture and 6 cases with intrinsic muscle contracture were received operative treatment. The pathogenic mechanism, clinical results, and prevention methods were studied in those 15 cases. RESULTS The postoperative function recovery was better in 4 cases, moderate in 5 cases with thumb adductor contracture, and better in 3 cases, moderate in 1 case with intrinsic muscle contracture, and moderate in 1 case, poor in 1 case with intrinsic muscle contracture of cord-like induration. Followed up 1 to 10 years, no recurrence was observed in all of 15 cases. The incidence and degree of thumb adductor contracture and intrinsic muscle contracture were closely related to the ischemia time of replanting graft. CONCLUSION Prevention of thumb adductor contracture and intrinsic muscle contracture is most important in severed palm or wrist replantation. When the ischemia time of replanting graft is longer than 12 hours, the effective decompression in myofascial compartment is performed in time to reach satisfactory result.

    Release date:2016-09-01 10:25 Export PDF Favorites Scan
  • REPLANTATION OF SEGMENTAL DESTRUCTIVE AMPUTATION OF MULTIPLE FINGERS

    OBJECTIVE: To discuss the indication of replantation of destructive amputation of multiple fingers for improvement of the function of injured fingers. METHODS: From February 1996 to August 1999, 23 amputated fingers in 8 cases were shortened and replanted. The crushed digital bones were fixed by Kirschner wires, flexor tendons repaired by Kessler suture technique, and digital extensor tendons repaired by mattress suture. The arteries and veins were anastomosed in each finger at the ratio of 1 to 2 or 2 to 3. The defect of blood vessels was repaired by free graft of autologous veins in 5 fingers. All of the cases were followed up for 10 to 18 months, and clinical evaluation was performed. RESULTS: All replanted fingers survived in the 8 cases, with good sensation, two point discrimination of 6 to 12 mm, and satisfied function, such as pinching, grasping and hooking. The fingers were shortened for 2.6 cm in average, ranging from 2.2 cm to 4.0 cm. CONCLUSION: Multiple digits replantation by shortening fingers is beneficial to functional restoration of segmental destructive fingers.

    Release date:2016-09-01 10:21 Export PDF Favorites Scan
  • SEGMENTAL RESECTION OF MALIGNANT TUMOR OF LOWER FEMUR AND REPLANTATION SUBSTITUTION OF THE THIGH BY DISTAL LEG

    T ree cases of sarcomas of theJ we femur were treated by region-a?ir? ation with overdosage of me-chlorethamine for 3 weeks and there-after a high amputation was done,and the distal leg was replantedwith the length that the anklewould act as a knee joint and thefoot pointing backword. Follow-upfor 1 -5 years discovered no me-tastasie of the tumor and the artifi-cial limb showed a better function.

    Release date:2016-09-01 11:41 Export PDF Favorites Scan
  • Research on the Influence of Three Postoperative Analgesia Methods on the Survival Rate of Replanted Finger by Flat Digital Subtraction Angiography

    ObjectiveTo observe the influence of three postoperative analgesia methods on the survival rate of replanted finger by flat digital subtraction angiography (DSA) medical imaging detection system. MethodFrom July 2014 to July 2015, 342 patients were classified into gradeⅠ and gradeⅡ replantation in accordance with their physical condition and they were randomly divided into routine oral group, muscle injection group and analgesia group with 144 patients in each. Flat DSA was used to dynamically observe replantation after revascularization. Then we compared the three different analgesia methods in terms of psychological status of the patients, incidence of vascular crisis, occlusion rate, survival rate of replanted fingers. The function score of replanted fingers was evaluated for clinical efficacy. ResultsCompared with the conventional oral group and muscle injection group, the incidence of vascular crisis in replanted fingers and thrombosis rate were significantly lower in the analgesia group which had a replanted finger survival rate of 96.69% and a normal mental condition rate of 78.07%. Six months after surgery, the rate of excellent and good follow-up was significantly higher than the conventional oral group and muscle injection group (P<0.017) . ConclusionsThe 3-D technology of flat DSA can provide clear and reliable pictures of vessel revascularization status for replanted fingers. The use of continuous brachial plexus analgesia performs better than other methods of analgesia. Good analgesia can stabilize patients' anxiety and negative emotions, which is helpful to avoid excessive fluctuations in blood pressure induced by small artery spasm caused by blood clots and vascular crisis, thereby increasing the survival rate of replanted fingers and facilitating early rehabilitation of their function.

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