Use a leaflet flap of foot to severed multi-finger with segmental injury / 中国骨伤

OBJECTIVE@#To explore asurgical methods for replantation of severed finger.@*METHODS@#From January 2018 to November 2022, 8 amputated-finger patients were performed surgical reconstructions by using polyfoliate free flaps with the first dorsal metatarsal artery, including 7 males and 1 female, aged from 20 to 55 years old, and defect areas ranged from (1.0 to 2.0) cm×(3.0 to 4.5) cm. Finger pulp sensation, shape and other relevant parameters were assessed following the upper extremity functional evaluation standard, which was put forward by Hand Surgery Branch of Chinese Medical Association. And maryland foot functional score was used to evaluate foot function.@*RESULTS@#Amputated fingers and flaps of all the 8 patients were survived. All patients were followed up for 4 to 20 months, their finger color and temperature tured to normal, with good wear-resistance and cold-resistance. According to Hand Surgery Branch of Chinese Medical Association, functional score ranged 61 to 92;4 patients got excellent result and 4 good. Maryland foot functional score ranged from 93 to 100;and 8 patients got excellent result.@*CONCLUSION@#It is feasible to repair severed fingers with soft tissue defects using polyfoliate free flaps that driven by the flippers of the first and second toes of the foot. This method ccould bridge blood vessels, increase soft tissue volume of the injured finger, and avoid finger shortening, with high patient satisfaction.

Veno-arteriolization in the field of hand surgery successful expansion / 国际外科学杂志

Objective To explore the clinical effect of Veno-arteriolization in digit replantation and reconstruction and transplantation of flap.Methods All clinical data of 49 cases of vascular special conditions were divide which received surgical treatment,21 cases in replantation group,5 cases in reconstruction group,23 cases in transplantation of flap group.All patients underwent veno-arterionlization.Results Two cases necrosis in transplantation of flap group,all the other fingers survived uneventfully.The patients were followed up for (4.5 ± 0.6)months.The outcome was satistactory both functionally and cosmetically in replantation and reconstruction groups.2-PD was (9.5 ±0.5) mm in replantation group,2-PD was (10.5 ± 1.0) mm in reconstruction group.The flaps had excellent appearance,good texture and color match in transplantation of flap group.According to the total active movement (TAM) evaluation system introduced by the American Society for Surgery of the Hand in 1975,the results of this series showed excellent in 42 cases,good in 5 cases and fair in 2 cases,the excellent and good rate was 95.9％.Conclusions Veno-arteriolization was a new method for hand surgery trauma in specially circumstances.Owing to its simple procedure,reliable effect,it worth to be spreading.

Investigation and research in constipation causes of patients undergoing replantation of severed finger / 中国实用护理杂志

Objective To investigate the factors that induce constipation in bedridden patients undergoing replantation of severed finger and find countermeasures. Methods A retrospective investigation was carried out in 92 patients undergoing replantation of severed finger, their constipation and factors influencing constipation were recorded. Results 61 patients suffered from constipation in total 92 cases,the rate being 66.30%. 76 patients reduced food intake, and 59 cases presented constipation (the rate being 77.63%). Factors influencing constipation included being unaccustomed to defecate in bed (the rate that present with constipation being 87.09%),reluctant to trouble others(75.47%), side effects of drugs(55.56%) and lack of dietary knowledge (71.87%), decreasing food intake was closely bound up with constipation. Conclusions Proper psychological counseling, strengthening of health propaganda, comfortable facility for defecation, improved family support and oral food intake can significantly reduce the proportion of constipation and increase comfort degree of patients.

Replantation to treat complex thumb severance / 中华创伤骨科杂志

Objective To discuss the methods and effects of replantation to treat complex thumb severance. Methods 56 cases of complex thumb severance combined with soft tissue defects were treated with simple vessel transplantation, veno flap transplantation, dorsal index digital island flap transplantation, digital artery transfer, transfer of radial index digital artery pedicled island flap, or veno arteriolization. The soft defects were repaired by the transfer of extensor index finger tendon and superficial ring finger flexor tendon. Results 50 cases survived and 6 cases failed, with the survival rate being 89%. 42 cases were followed up for 5 to 25 months. The function of the treated thumbs was assessed as excellent in 10, good in 25 and bad in 7. The excellent and good rate was 83%. Conclusion Complex thumb severance can be treated by unconventional replantation so as to achieve good effects.