【摘要】 目的 探讨保留关节的断腕再植治疗效果。方法 选取2012年4月-2015年4月收治的腕部离断伤患者20例,采用保留关节的断腕再植法对其进行治疗。在处理骨、关节及神经、肌腱、血管时,尽量使断端原位对合吻接,做到原位再植。术后给予适当的治疗、恰当的外固定以及早期的功能锻炼,使患者的治疗系统化。结果 断腕再植的20例全部成活。根据中华医学会手外科学会断肢再植功能评定试用标准评定,优14例,良6例,优良率100%。术后随访6～36个月,其手功能恢复良好,拇指能与示、中、环、小指作对指活动,腕关节及掌指、指间关节的主动活动度均大于60°,皮肤的感觉也有不同程度的恢复。结论 腕部离断伤采用保留关节的原位再植术,术后腕部在外观、灵活性、稳定性及功能上都得到最大程度恢复,取得了良好的临床效果,值得临床广泛推广。更多还原

【Abstract】 Objective To explore the clinical effect of reserving articular replantation on amputated wrist.Methods Twenty cases were selected from April 2012 to April 2015 in our hospital, by using the method of preserving joints, the ampulated wrist was replanted. In the treatment of bone and joint and nerves,tendons, blood vessels, did best to anastomosis in situ replantation. The cases were gave appropriate treatment and proper postoperative external fixation and early functional exercise, made the treatment of patients systemic. Results Twenty cases of ampulated wrist replantation all survived. According to the Chinese medical association’s ampulated limb replantation function evaluation trial standards, excellent in14 cases, good in 6 cases, and the excellent and good rate was 100%. Postoperative followed-up for 6～36 months, the recovery of hand function was good, the thumb could opposite to middle, ring and little finger. The active range of motion of wrist, metacarpophalangeal, interphalangeal joint was greater than60°, the skin feeling also had different degrees of recovery. Conclusion The wrist in situ replantation reserving wrist has postoperative maximum recovery on appearance, flexibility, stability and function and good clinical effect, is worth popularizing in clinic widely.更多还原