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| 題 名 | 拇指之斷指再接植手術 |
|---|---|
| 作 者 | 陳明庭; | 書刊名 | 中華民國外科醫學會雜誌 |
| 卷 期 | 16:2 1983.06[民72.06] |
| 頁 次 | 頁219-225 |
| 分類號 | 416.615 |
| 關鍵詞 | 拇指; 斷指; 再接植手術; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 分析我們近三年來所作的拇指斷指再接植手術的54個為例中,成功率僅為83%較所有手指的斷指再接植術的89%的成功率為低,雖失敗的病例以壓碎傷佔大多數,但其原因與拇指的特殊解剖情形及其複雜的血管結構組織之分佈有密切關係。大多數的病例,如果斷端在第二帶(Zone II) (表4 )及第三帶(Zone III)遠端部位,仍然可用傳統上的末端對末端的血管直接接合術來完成再接植手術。部份較困難的病例,為斷端在接近掌指關節(M- P Joint)處。因為此處大拇指之指動脈(Digital Artery)的近端就有一些分枝支配掌魚際肌(Thenar Muscle),所以為了分離其近端,就有可能傷到這些分枝,為保留拇指之最大功能恢復應考慮用靜脈移植作動脈血管分流(by- pass),如此始能保全掌魚際肌之正常血液循環才可使手術成功率提高。這是拇指截斷再接植時,因解剖上之奇特情況,值得學者提高警覺。 |
| 英文摘要 | During past 3 years (1980-1982) we experienced 54 thumb replantations. The successful rate of thumb is 83% and compared with our over all digital replantation 89% it is obviously lower. Although most of our un-successful cases were crush injury, yet the failure was closely related to the specific feature of anatomical vascular structure. If the level of amputation was on Zone II, the repair has no too much difference with other digit, using conventional end to end vascular anastomosis. But when the amputation was at Zone III or even more proximal, the end to end anastomosis should not be attempt and the best choice was to use a vein graft to by-pass the blood stream from radial artery near by wrist to make end to side at proximal and end to end at distal. In such we can preserve good blood supply of thenar muscles without interrupt its small nutritional branches, then we can get both higher successful rate and a better functional result. |
本系統中英文摘要資訊取自各篇刊載內容。