ABSTRACT
Objective To report microsurgical treatment of severed palm caused by crush injury. Methods From 1998 to 2002, 14 patients with severed palm and destructive crush injury were treated in our hospital. According to the specific severity and level of different injuries, replantation of severed palm with vessel transfer, replantation of fingers to the distal forearm with resection of wrist and palm, replantation of severed palm combined the thumb reconstruction were applied to reserve a maximal part of hand or fingers. Results Of the 14 cases of replantation, 3 experienced death of middle or index finger and the others all survived. The follow up of 11 cases lasted more than 6 months. After functional exercises, 10 cases recovered the function of pinch, and 1 case nearly regained normal functions. All of them regained sensation and the two point discrimination was 8 to 10 mm. Conclusion Reasonable replantation for severed palm with crush injury is still a method to regain part of hand functions.
ABSTRACT
The arteries of thirty human adult upper extremities, injected with red lead oxide, were treated with angiography, sectional dissection and photography. A microcomputer was used to determine the positions of the vessels and reconstruct the arterial system of the hand.The arteries of the palm are arranged in 2 or 3 layers. The area of three layers were only observed in the middle portion of the palm. The divisions of the territories of the radial and ulnar arteries are not the same in different layers. The anastomotic branches in the palmo-dorsal direction are usually observed in the third, fifth and seventh sections. There are three chief anastomotic channels between the radial and ulnar arteries in the palm, i.e. the deep palmar arch, the superficial palmar arch and a third pathway. The patterns of the blood supply in the palm and its clinical significance have also been discussed.