Replantation of severed fingers

Introduction

Introduction to replantation of broken fingers The key to the success of replantation of the severed finger is whether the blood vessel can be connected. In 1965, Kleinert applied a magnifying glass to connect the finger vessel and Buncke and other microsurgical techniques to successfully perform rabbit ear replantation and monkey replantation. In 1966, Chinese medical staff and Japanese scholar Komatsu (1968) successively reported the successful re-invasion of the thumb. At present, the success of high-difficult surgery such as pediatric finger replantation, finger replantation, and ten-finger re-implantation indicates that microsurgery has reached a new height. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific people Mode of infection: non-infectious Complications: edema

Cause

Broken finger replantation cause

Trauma, crush injury, trauma, etc.

Prevention

Broken finger replantation prevention

Pay attention to production, safety of life, and no other effective preventive measures.

Complication

Broken finger replantation complications Complications edema

Easy to concomitant infections, etc.

Symptom

Symptoms of replantation of severed fingers Common symptoms Squeeze dehydration edema refers to (toe) swelling, blood stasis, finger pain

Surgical contraindications

1. Suffering from systemic diseases, poor physical condition, or complicated with serious organ damage, it is not allowed to replant for a long time.

2. Broken finger with multiple fractures or severe soft tissue injury,

3. The integrity of the integrity of the finger vascular bed is severe, such as the finger breakage caused by crush injury, which is manifested by subcutaneous blood stasis on both sides of the finger. Even if the blood vessel is connected, the soft tissue is extensively oozing, thrombosis, and replanting the finger is still difficult to survive. ,

4. If the replantation time limit is excessively exceeded and the tissue has undergone degeneration, it is not suitable for replantation. If it is not refrigerated, the finger can still replant after 24 hours of ischemia. If it is injured, it should be refrigerated and the time limit for replantation can be extended to 30 hours. Above, but the shorter the ischemic time, the higher the replantation survival rate. Conversely, the longer the ischemic time, the lower the replantation survival rate.

Surgical indication

1. Breaking the thumb and replanting the thumb is the most important in the function of the hand. When replanting, it should be given priority. Try to fight for the early repair of the thumb. When the condition of the thumb is not good, you can use the broken index finger to replant. On the thumb, the index finger tendons are transferred to the vascular bundle or after revascularization or reconstitution of the thumb.

2. Replantation of the remaining 4 fingers From the functional point of view, the food and the middle finger are more important. For the conditional replantation, the middle finger should try to replant, and other fingers except for occupations or other factors have special needs. There is no need to replant, the reason is that the restriction of the range of motion of the knuckles after the finger replants will affect the function of the entire hand.

3. Replantation of the distal segment is mainly because the distal interphalangeal joint is separated by a far finger, because the function of losing the distal opponent is not affected, so it does not advocate replanting, and the simple in situ suture also has a certain survival rate. In addition to the functional needs of certain special occupations of patients, psychological and cosmetic requirements, it can also be replanted.

4. Some liquid-soaked fingers replanted incorrectly soaked the finger in hypotonic, isotonic, hypertonic or some disinfectant, or improperly stored, ice cubes melted after the ice melted, due to the semi-permeable membrane The role of hypotonic night makes the cells edema and swell, hypertonic fluid dehydrates the cells, and some disinfectants such as ethanol, phenyl potassium bromide, thimerosal, etc. directly damage the cells of vascular endothelial cells and other tissues, depending on the type, The concentration and soaking time are different, the degree of damage is different, and there are different effects on survival. The conditions allow for replantation.

5. The treatment of the damaging damage of the wrist of the wrist is severely damaged or broken away from the distal part of the forearm, and the distal fingers are still intact. At this time, the rotted wrist can be removed and thoroughly cleaned. After the creation, the more complete fingers were fixed on the ulna and the tibia, and the replantation of the palm was performed.

Examine

Check of replantation of severed fingers

A routine examination is required before surgery.

Diagnosis

Broken finger replantation diagnosis

Combined with the diagnosis of medical history, no need to identify.

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