指骨延长与关节成形修复再植手指短缩焦伟12王斌2马铁鹏2摘要.DOC

指骨延长与关节成形修复再植手指短缩 焦伟、2 王斌2马铁鹏2 摘要 目的：探讨指骨延长与关节成形修复再植术后手指短缩畸形的临床效果。方法：2009年2月~2013年1月对15例患者行指骨延长与关节成形术。男8例，女7例；年龄14岁~41岁，平均23岁。拇指1例，示指8例，中指6例，均为再植术后手指短缩1.5cm以上者。再植术后去除固定物3个月后行指骨延长术。达到预期长度去除外固定延长器1月后行指间关节成形术。结果：术后患者均获得随访，随访时间12月~35月（平均21.3月），平均延长1.8cm。采用国际手外科学会的复合损伤的复合评定公式A%+B%复合值=A%+B%×(100%-A%)评价，术后手指复合损伤较术前平均下降30.6%。结论：对于手指再植术后短缩畸形患者行指骨延长与关节成形术，可降低手指复合损伤值，较好的改善手功能，获得比较满意的临床效果。 关键词掌指骨延长 PHALANX-LENGTHENING AND ARTHROPLASTY METHODS .JIAO Wei(, WANG Bin, MA Tiepeng. 1. (Department of hand and foot surgery，Shengli Oilfield Central Hospital,Hospital Affiliated to Bin Zhou Medical University ,DongyingShandong，257000,P.R.Chian.2.Department. of.surgery,Tangshan NO.2 Hospital，Orthopedic Hospital Affiliated toHe Bei United University,TangshanHebei,063000,P.R.Chian.Correspondingauthor:JIAOWei,E-mail:jiaowei850429@163.com ;WANGBin,E-mail:wbladyp3@. Abstract Objective To investigate the clinical efficacy of repairing replanted fingers with phalanx-lengthening method and Arthroplasty method.Methods Between February 2009 and January 2013,15 patients with replanted fingers were treated with phalanx-lengthening and Arthroplasty methods. There were 8 males and 7 females, age 14~41 years.(mean,23 years). All the cases suffered from complete amputation and the finger were shortenign than they were more than 1.5cm. There were 1 case in which the thumb, index finger in 8 cases, 6 cases of the middle finger. Phalanx-lengthening can be carry out for 3 months after the replantation operation.One months later, in the second stage of the arthroplasty can be operate when the bone lengthing achieve the desired results.Results: All the patients were followed up 12 months to 35 months with an average of 21.3 months. At last follow-up ,fracture union was achieved in most of patients . The mean length increase was 1.8cm. The assessment method was used A%+B%value=A%+B%?100%-A%).Them Composite damage assessment of the value were reduced by 30.6%.Conclusions：Phalanx-lengthening and Arthroplasty