Effectiveness of combined tissue transplantation to repair serially damaged injuries on radial side of hand_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

MI Shouhu ,  TENG Yunsheng , LIANG Gaofeng , DUAN Chaopeng , ZHANG Manying , JIA Zonghai , ZHANG Wei , WANG Zenghui , WEN Bo , DONG Junwen , GUO Yongming

Department of Hand Microsurgery, 521 Hospital of Norinco Group, Xi’an Shaanxi, 710065, P.R.China;

Corresponding?author：

TENG Yunsheng, Email: 1156982650@qq.com

Keywords：

Hand; damaged injury; tissue flap; combined transplantation; wound repair; functional reconstruction

DOI：

10.7507/1002-1892.202012068

Video：

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Objective To investigate the effectiveness of combined tissue transplantation for repair of serially damaged injuries on radial side of hand and function reconstruction. Methods Between May 2013 and May 2017, 34 cases of serially damaged injuries on radial side of hand were treated. There were 29 males and 5 females; aged 17-54 years, with an average of 32.1 years. There were 23 cases of crushing injuries, 5 cases of bruising injuries, 4 cases of machine strangulation injuries, and 2 cases of explosion injuries. The time from injury to admission was 40 minutes to 3 days, with an average of 10 hours. According to the self-determined serially damaged injuries classification standard, there were 1 case of typeⅠa, 2 cases of typeⅠb, 10 cases of typeⅡa, 5 cases of type Ⅱb, 3 cases of type Ⅱc, 1 case of type Ⅱd, 7 cases of type Ⅲa, 3 cases of type Ⅲb, 1 case of type Ⅲc, and 1 case of type Ⅲd. According to the classification results, the discarded finger, nail flap, the second toe, anterolateral thigh flap, ilium flap, fibula flap, and other tissue flaps were selected to repair hand wounds and reconstruct thumb, metacarpal bones, and fingers. Results After operation, 2 cases of flaps developed vascular crisis and survived after symptomatic treatment; the other transplanted tissue survived smoothly. All cases were followed up 1 to 7 years, with an average of 2.4 years. The average fracture healing time was 7.4 weeks (range, 5.3-9.0 weeks). At last follow-up, the reconstructed fingers and the grafted flaps recovered good sensory function, with a two-point discrimination of 5 to 11 mm (mean, 9 mm). According to the evaluation standard of the upper limb function evaluation of the Chinese Medical Association Hand Surgery Society, the reconstructed thumb was rated as excellent in 24 thumbs, good in 8 thumbs, and fair in 2 thumbs; the reconstructed finger was rated as excellent in 18 fingers, good in 2 fingers, and fair in 1 finger. Conclusion For the serially damaged injuries on radial side of hand, according to its classification, different tissues are selected for combined transplantation repair and functional reconstruction, which can restore hand function to the greatest extent and improve the quality of life of patients.

Citation： MI Shouhu, TENG Yunsheng, LIANG Gaofeng, DUAN Chaopeng, ZHANG Manying, JIA Zonghai, ZHANG Wei, WANG Zenghui, WEN Bo, DONG Junwen, GUO Yongming. Effectiveness of combined tissue transplantation to repair serially damaged injuries on radial side of hand. Chinese Journal of Reparative and Reconstructive Surgery, 2021, 35(5): 601-604. doi: 10.7507/1002-1892.202012068 Copy

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2.	吳學仁, 魏盼杰, 趙耀華, 等. 髂腹股溝復合組織瓣修復手足部皮膚軟組織缺損的效果. 中華燒傷雜志, 2020, 36(8): 722-725.
3.	王云鋒, 沈昊, 楊敏, 等. 取掌長肌移植聯合多種皮瓣修復多指復合組織缺損. 中華手外科雜志, 2020, 36(3): 236-238.
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6.	余志平, 于曉峰, 叢海波, 等. 復雜拇指缺損合并橈側大面積皮膚缺損的重建與修復. 實用手外科雜志, 2017, 31(2): 233-235.
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10.	滕云升, 郭永明, 智豐, 等. 組織聯合移植修復手部毀損傷的臨床應用. 中華手外科雜志, 2013, 29(2): 92-94.
11.	Jorm L. Firework injuries in New South Wales, 1992-93 to 2001-02. N S W Public Health Bull, 2003, 14(6): 110-113.
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13.	程國良. 不同形式的足趾移植拇手指再造與修復. 中華顯微外科雜志, 2002, 25(1): 8-9.
14.	李兵, 俞光榮, 楊云峰, 等. 兩種第二趾切取游離移植對供足足底應力影響的生物力學研究. 中華創傷骨科雜志, 2010, 12(9): 869-872.
15.	林立, 顏磊, 葉潤棠, 等. 腓骨皮瓣移植重建第 1 跖骨及第 2 跖骨頭復合組織缺損一例. 中華顯微外科雜志, 2019, 42(5): 515-516.
16.	Taccardo G, DE Vitis R, Parrone G, et al. Surgical treatment of trapeziometacarpal joint osteoarthritis. Joints, 2014, 1(3): 138-144.
17.	梁高峰, 智豐, 滕云升, 等. 游離股前外側肌皮瓣加植皮修復手掌背軟組織缺損. 中華手外科雜志, 2015, 31(4): 320.
18.	郭洪娟, 鄧高麗, 馮璐, 等. 醫護一體化護理模式在手部毀損傷病人術后功能康復中的應用. 護理研究, 2017, 31(18): 2254-2256.

1. 莫勇軍, 程志琳, 許林, 等. 3D 打印技術輔助修復手橈側嚴重毀損傷九例. 中華顯微外科雜志, 2018, 41(4): 334-338.
2. 吳學仁, 魏盼杰, 趙耀華, 等. 髂腹股溝復合組織瓣修復手足部皮膚軟組織缺損的效果. 中華燒傷雜志, 2020, 36(8): 722-725.
3. 王云鋒, 沈昊, 楊敏, 等. 取掌長肌移植聯合多種皮瓣修復多指復合組織缺損. 中華手外科雜志, 2020, 36(3): 236-238.
4. 詹宏鋼, 湯樣華, 徐燦達, 等. 復合組織瓣移植修復伴有伸肌腱缺損的指背軟組織缺損創面. 中華手外科雜志, 2020, 36(3): 238-240.
5. 謝慶平, 徐潤龍, 石仕元, 等. 組合組織移植在修復手毀損傷中的應用. 中華手外科雜志, 2001, 17(3): 148-150.
6. 余志平, 于曉峰, 叢海波, 等. 復雜拇指缺損合并橈側大面積皮膚缺損的重建與修復. 實用手外科雜志, 2017, 31(2): 233-235.
7. 金光哲, 王凱, 熊勝, 等. 伴有虎口區皮膚缺損的拇指缺損再造. 中華手外科雜志, 2016, 32(5): 334-335.
8. 潘達德, 顧玉東, 侍德, 等. 中華醫學會手外科學會上肢部分功能評定試用標準. 中華手外科雜志, 2000, 16(3): 130-135.
9. 廖堅文, 張振偉, 莊加川, 等. 手橈側毀損傷分型初步探討. 中華手外科雜志, 2010, 26(4): 216-218.
10. 滕云升, 郭永明, 智豐, 等. 組織聯合移植修復手部毀損傷的臨床應用. 中華手外科雜志, 2013, 29(2): 92-94.
11. Jorm L. Firework injuries in New South Wales, 1992-93 to 2001-02. N S W Public Health Bull, 2003, 14(6): 110-113.
12. Vassilia K, Eleni P, Dimitrios T. Firework-related childhood injuries in Greece: a national problem. Burns, 2004, 30(2): 151-153.
13. 程國良. 不同形式的足趾移植拇手指再造與修復. 中華顯微外科雜志, 2002, 25(1): 8-9.
14. 李兵, 俞光榮, 楊云峰, 等. 兩種第二趾切取游離移植對供足足底應力影響的生物力學研究. 中華創傷骨科雜志, 2010, 12(9): 869-872.
15. 林立, 顏磊, 葉潤棠, 等. 腓骨皮瓣移植重建第 1 跖骨及第 2 跖骨頭復合組織缺損一例. 中華顯微外科雜志, 2019, 42(5): 515-516.
16. Taccardo G, DE Vitis R, Parrone G, et al. Surgical treatment of trapeziometacarpal joint osteoarthritis. Joints, 2014, 1(3): 138-144.
17. 梁高峰, 智豐, 滕云升, 等. 游離股前外側肌皮瓣加植皮修復手掌背軟組織缺損. 中華手外科雜志, 2015, 31(4): 320.
18. 郭洪娟, 鄧高麗, 馮璐, 等. 醫護一體化護理模式在手部毀損傷病人術后功能康復中的應用. 護理研究, 2017, 31(18): 2254-2256.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness of combined tissue transplantation to repair serially damaged injuries on radial side of hand

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