最新断肢(指)再植.pptVIP

History 当前1页，共35页，星期二。 第一页，共三十五页。 陈中伟：王存柏病例 In January second,1963， Machine cut January, cold weather Amputated part wrapped in towel Reach hospital within 1 hour 当前2页，共35页，星期二。 第二页，共三十五页。 But, this time….. 当前3页，共35页，星期二。 第三页，共三十五页。 World First Hand Replantation 当前4页，共35页，星期二。 第四页，共三十五页。 Do you like this lesson? Do you want to be a surgeon as Chen Zhongwei? 当前5页，共35页，星期二。 第五页，共三十五页。 Learning Outline Definition and History 定义和历史 Classification 分类 Anatomy 解剖 Amputated parts storage and transportation 断指的保存和早期处理 Indications ?适应症 Surgical technique in sequence 再植手术顺序 Post-operative care 术后处理 当前6页，共35页，星期二。 第六页，共三十五页。 Definition The surgical reattachment of a limb / digit, that has been completely cut from a persons body, restore the blood circulation, so that limb / digit to get the survival and recovery. 将完全离断的四肢/手指重新接上，恢复其血液循环，使断肢/指得到存活和恢复功能的手术。 当前7页，共35页，星期二。 第七页，共三十五页。 H?fner 1903 Animal survival Jacobson Suarez 1960 Small vessel 屠开元 1960 Dog Replantation Malt 1962.5 Arm 陈中伟 1963.1 Hand Komatsu Tamai 1965 Fingers 陈中伟 1966 Fingers History 当前8页，共35页，星期二。 第八页，共三十五页。 Classcification regular cut and Ring Avulsion Finger tip amputation Anatomy After surgery Good bone union Ring Avulsion Amputation 脱套伤 After surgery 当前9页，共35页，星期二。 第九页，共三十五页。 Classcification: one or multiple fingers Pre-OP Later post-OP Post-OP 当前10页，共35页，星期二。 第十页，共三十五页。 Classcification: Forearm amputation Pre-OP Later post-OP 当前11页，共35页，星期二。 第十一页，共三十五页。 Classcification: Upper arm amputation Pre-OP Post-OP Later post-OP 当前12页，共35页，星期二。 第十二页，共三十五页。 Anatomy of Digits The fingers are supplied by vessels and nerves which run up the lateral aspects of each digit. 当前13页，共35页，星期二。 第十三页，共三十五页。 Hand Anatomy Because of junctura(肌腱联合), a complete tendon laceration proximal to the junctura may still result in normal extensor function. The flexor tendons are enclosed in synovial sheaths （滑液鞘） making them easy to deep space infections 当前14页，共35页，