再植手指短缩的骨延长治疗

焦伟[1]

【摘要】 目的：探讨缓慢牵伸延长修复再植手指短缩畸形的临床疗效。方法： 2009年10月~2013年6月，采用指骨缓慢牵伸延长术治疗再植手指短缩畸形30例。男19例，女11例，年龄14~41岁，平均23.4岁；其中拇指2例，示指9例，中指8例，环指5例，小指6例。结果：30例病人术后均获得随访，随访时间12~22月，平均15.9月，术后延长骨愈合优23例、良4例、可2例、差1例，优良率90%；末次随访时指骨平均延长17.5±3.4mm；两点辨别觉平均增加0.6mm；指端血氧饱和度平均减少0.8%；延长指骨近端关节功能损伤评定值平均增加0.5%、远端关节功能损伤评定值平均增加0.2%；手指复合损伤的复合评定值减少23.4%。与术前比较指骨显著延长、手指复合损伤的复合评定值下降，差异有统计学意义（P<< span="">0.05）；两点辨别觉、指端血氧饱和度、关节活动度无明显改变，差异无统计学意义（P>0.05）。结论：应用指骨延长器缓慢牵伸延长修复重建再植短缩的手指是一种较好方法。在修复再植手指短缩畸形中具有一定优势，且近期临床效果满意。

【关键词】掌指骨延长 伊利扎诺夫原理 肢体延长 外固定延长器 骨缺损

REPAIR OF REPLANTED FINGERS OF SHORTENED BONES WITH PHALANX-LENGTHENING METHOD /JIAO Wei, Department of hand and foot surgery，Shengli Oilfield Central Hospital,Hospital Affiliated to Bin Zhou Medical University ,DongyingShandong，257000.

【Abstract】 Objective: To investigate the clinical efficacy of repairing replanted fingers with phalanx-lengthening method.Methods : Between Otober 2009 and June 2013,30 patients with replanted fingers were treated with phalanx-lengthening. There were 19 males and 11 females, age 14~41 years.(mean,23.4 years). There were 2 cases in which the thumb, index finger in 9 cases, 8 cases of the middle finger, ring finger in 5 cases, 6 cases of little finger. Results: All the patients were followed up 12 to 22 months with an average of 15.9 months. At last follow-up ,fracture union was achieved in most of patients . The case function were excellent in 23 cases, good in 4 cases, fair in 2 cases, poor in 1 cases, and the excellent and good rate was 90.0%. Last follow-up to extend the total length of the average phalanx extended 17.5 ± 3.4mm; Average the two-point discrimination increases by 0.6mm；Finger oxygen saturation decreased by 0.8% on average; Extension of the proximal phalanx joint dysfunction assessed value increased by an average of 0.5%、Distal joint dysfunction assessed value of an average increase of 0.2%；Damage assessment of composite finger composite value decreased 23.4%.Extend the length of the phalanx and Damage assessment of composite finger composite value were obviously improved when compared with preoperative ones, showing significant difference (P<0.05). other’s was not significant（P>0.05）.Conclusions：phalanx-lengthening can be a method in the treatment of replanted fingers. The method has certain advantages than other methend and short-term clinical results were satisfactory.

【Key words】 Metacarpal and Phalange lengthening Ilizarov technique Limb lengthening Synchronous lengthening device Bone defect

作者单位:1胜利油田中心医院 滨州医学院附属医院 手足外科（山东东营，257000）通讯作者：焦伟，骨外科硕士研究生，研究方向：手足外科、显微外科，E-mail:jiaowei850429@163.com

《再植手指短缩的骨延长治疗》详见：中国骨与关节损伤杂志，2014.29（5）63-64