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- Digital Replantation at The Level of The Distal Interphalangeal Joint and The Distal Phalanx--A Ten Years Review
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題名 | Digital Replantation at The Level of The Distal Interphalangeal Joint and The Distal Phalanx--A Ten Years Review=遠端指關節及遠端指骨之斷指重接--十年之回顧 |
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作者 | 林文正; 呂旭彥; 張士人; 邱浩遠; 林佐武; 林志和; 吳肇權; 吳瑞星; 林俊良; | 書刊名 | 中華民國重建整形外科醫學會雜誌 |
卷期 | 3:2 1994.06[民83.06] |
頁次 | 頁67-74 |
分類號 | 416.615 |
關鍵詞 | 遠端指關節; 遠端指骨; 斷指重接; Amputation; Replantation; Distal interphalangeal joint; |
語文 | 英文(English) |
中文摘要 | 國泰醫院從1980年到1989年共有877隻斷指重接,其中有93隻是位於遠端指關節及遠端指骨,依據Tamai氏對斷指重接之分類,即為第一及第二區。其成功率為80.6%,平均年齡為25.5歲,有35%是發生在拇指,男女之比率為25.8比1,平均住院天數為8.33天。根據統計,我們發現重接成功率和年齡、性別、 缺血時間、是否為完全地截肢無關,而與血管重接之數目,特別是靜脈之重接數有關。對於此處斷指重接之處理方式,使用顯微重接手術與傳統其它手術形式有以下不利之處:需要有嫻熟之顯微手術技巧、較長之手術時間及較昂貴之醫療費用。其好處有:其為一次可完成之手術、好的指尖組織覆蓋、良好的感覺恢復且少有神經瘤產生、保留指甲、維持較長的指頭長度、較美觀、且能使醫師及病患都能滿意。 |
英文摘要 | There were 877 amputated digits replanted from 1980 to 1989 in CGH. Ninety-three digits (all analyzed with the Tamai’s digital replantation classification) were at or above the level of distal interphalangeal joint and all were reviewed. The successful rates of zone I and Ⅱwere 80.6%. The average age of the patients was 25.5 years old and 35% of the cases involved the thumb. The male to female ratio was 2.58:1. The average days of hospitalization were 8.33. The successful rates were not correlated with sex, age, ischemic time, or complete/incomplete amputation, but related with the vessels anastomosed, especially with the number of veins. Compared with conventional procedures, the disadvantages of replantation over zone I & Ⅱare: the operator requires skillful microsurgical techniques, prolonged operation hours, and more expensive medical fees. The advantages are: one-stage procedure, good distal soft tissue coverage, adequate sensibility without painful neuroma, preservation of the nail, maintainance of digit length, cosmetically pleasing, and satisfaction by both the patient and surgeon. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。