Artikel
The classification of mutilated injuries of the hand and the methods and the clinical outcomes of such injuries reconstructed
Suche in Medline nach
Autoren
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Yonming Guo
- Weapons Industrial Health Institute (521 Hospital), Xi An, China
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Yunsheng Teng
- Weapons Industrial Health Institute (521 Hospital), Xi An, China
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Gaofeng Liang
- Weapons, Industrial Health Institute (521 Hospital), Xi An, China
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Junwen Dong
- Weapons Industrial Health Institute (521 Hospital), Xi An, China
| Veröffentlicht: | 10. Oktober 2017 |
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Gliederung
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Objectives: To investigate the classification of mutilated injuries of the hand and the methods and the clinical outcomes of such injuries reconstructed.
Method: From October 1996 to October 2011，a retrospective study of 195 cases of mutilated injuries of the hand was carried out, including 341 fingers. The injuries were divided into two types, including simple type and complex type.The simple type of mutilated injuries of the hand was reconstructed by the following methods of the hallux nail flap, the part of the second phalange transplanted, modified reconstruction, and full-shaped reconstruction. The complex type was divided into seven subtypes, which were reconstructed primarily by the composite methods of the free anterolateral thigh flap, the hallux nail flap, the part of the second phalange transplanted, dorsalis peals flap .
Results: Venous crisis happened in 14 cases, thrombus formed in anastomosis, venous crisis was solved by vascular grafted and the blood vessels re-matched. Arterial crisis happened in 8 cases, thrombus formed in 2 cases, arterial crisis was solved by vascular grafted and the blood vessels re-matched. Vascular pedicle reversed in 3cases, arterial crisis was solved by re-adjusting the place of the blood vessels and re-anastomosis. Soft tissue tension is too large in 3 cases , arterial crisis was solved by re-stitching the wound and skin grafted. The distal part of the flap was necrosis in 6 cases, the wound healed by debridement and skin grafted, the rest of the organization survived primarily. According to the upper limb function of the Chinese Medical Association Hand Surgery Society, the upper limb partial function of the evaluation trial standard：reconstructed thumbs were excellent in 60 cases，good in 33 cases, fair in 16 cases, reconstructed fingers were excellent in 87 cases，good in 114 cases, fair in 23 cases, poor in 8 cases.
Conclusion: The classification of mutilated injuries of the hand is useful for the selective of proper operative procedures, it guides and regulates the reconstruction of mutilated injuries of the hand, the clinical outcome is satisfactory with a good appearance and function after reconstruction．
