摘要
目的报告一例上臂高位断肢再植的治疗结果。方法对1例左上臂高位断肢患者的病史,术后功能的恢复进行分析。结果本例患者术后再植肢体肿胀不明显,创面一期愈合。139d后,手指出现轻微的屈指运动,6个月后,左手出现触觉痛,8个月后,骨折线模糊,主动运动肩关节外展30°,前屈20°,肘关节屈75°,伸0,腕关节背伸0,掌屈15°,大小鱼际肌及手内在肌轻度萎缩,呈爪形手,被动屈曲时指尖能接近掌指关节,伸指受限,被动活动度达正常范围,腕关节近端痛觉,触压觉及温冷觉明显恢复,左手感觉尚未恢复。结论上臂高位离断再植的适应症是肢体完整,缺血时间短,神经非根性撕脱伤,且患者年轻,全身情况良好,应尽量给予再植。
Objective To discuss the indications for replantation of high severed upper arm, only a few successful cases of which have been reported home and abroad. Methods The medical history and functional recovery of the patient who underwent replantation of high severed upper arm was analyzed after operation. Results The replanted upper arm was not very tumid and the wound primarily healed after operation. After 139 days, some callus appeared at the humeral breakpoints, and the fingers began to flex slightly. 6 months later, the replanted upper arm could feel pain and touch. 8 months later, the fracture line began to disappear, the initiative abduction of the shoulder could reach 30°, the ranges of elbow joint flexion and extension 75°and 0 respectively, the range of dorsal flexion of wrist joint 0, and palm flexion 15°. Slight atrophy appeared in hypothenar muscle and intrinsic hand muscle. Fingertips could approach palm phalangeal joint in passive motion, but fingers extended restrictedly. Ranges of passive motion were normal, the proximal wrist could feel pain, touch, coldness and warmth, but the hand could feel nothing. Conclusion Indications for replantation of high severed upper arm are integrity of the extremities, short-time bleeding, non-root avulsion of nerves, youth and good health.
出处
《中华创伤骨科杂志》
CAS
CSCD
2004年第8期952-953,共2页
Chinese Journal of Orthopaedic Trauma
关键词
再植术
上臂高位断肢
显微外科
治疗
Replantation
High severed upper arm
Microsurgery
Treatment outcome
