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求助翻译CROSS-DIGITAL VEIN GRAFT IN ARTERIAL REPAIR
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A 21-year-old man presented with a severe crush injury to the index and long fingers of his left hand. All structures, except for one slip of the superficial flexor tendon in the long finger and the dorsal skin and veins in the index finger, were amputated at the level of the distal part of the midphalanx. There was no perfusion in the stumps. The stumps were irrigated with saline solution and debris was removed. The proximal bones were minimally debrided, and small, loose bony fragments were removed. Bony fixation was performed using single axial Kirschner wires. The extensor tendons were repaired with a horizontal mattress suture technique using 4-0 nylon suture; the flexor tendons were repaired with a modified Kessler suture technique using 4-0 nylon suture. All microsurgical repairs were performed with 10-0 nylon sutures under magnification with a surgical microscope. Primary nerve repairs were performed on the radial and ulnar digital nerves in both fingers and two vein anastomoses were performed in the long finger. Since there were intact veins in the index finger, we did not perform vein anastomoses. Radial and ulnar digital arterial anastomoses were performed in the long finger. Since the proximal part of the radial digital artery and the distal part of the ulnar digital artery of the index finger were severely injured, the classic end-to-end arterial anastomoses could not be performed. We used a vein graft, taken from the volar site of the elbow, between the intact proximal ulnar digital artery and the distal radial digital artery in an antidromic position (Fig. 1). While skin grafting was used over the vein graft and arterial anastomoses, primary closure was preferred at the other sites. Four weeks postoperatively, the Kirschner wires were removed and passive physiotherapy was started. Six weeks postoperatively, the patient began active range-of-motion exercises. Objective testing showed a satisfactory range of active distal interphalangeal joint motion (50 degrees in the long finger and 55 degrees in the index finger) at 5 months postoperatively. The average two-point discrimination of the pulp was 12 mm in the long finger and 11 mm in the index finger. No nail deformity, cold intolerance, or pulp atrophy was seen. Sample Text [search]CROSS-DIGITAL VEIN GRAFT IN ARTERIAL REPAIR[/search] [ Last edited by zxd2006676 on 2007-11-26 at 11:04 ] |
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lililong0
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一名21多岁男子介绍，与严重挤压伤，以指数和长期手指他的左手。所有的建筑物，除上述一溜浅屈指肌腱，在长期和手指背皮肤和静脉指数手指被截肢在这一级别的远端部分的midphalanx 。有没有灌注在树桩。该树桩被灌生理盐水和碎片被拆掉。近端骨微清创，又小， 松骨碎片被拆除。骨内固定手术采用单轴向克氏针。伸肌腱修复横向褥式缝合技术，用4-0尼龙线;屈肌肌腱维修与改装凯斯勒缝合技术用4-0尼龙缝线。所有显微外科维修与10-0尼龙缝线下放大与手术显微镜。小学神经修理，对径向 和尺数字神经都手指和两个静脉吻合表演在漫长的手指。由于有完整的脉中的食指我们的确不履行静脉吻合。尺桡骨数码动脉吻合演出在长期手指。由于近端部分的径向数码动脉远端部分的尺指动脉的食指被严重受伤，经典的端到端动脉吻合不能演出。我们用静脉移植，从掌部位肘之间， 完整近端尺动脉及桡远端指动脉是一个逆向位置（图1 ） 。而植皮，使用超过静脉移植和动脉吻合，缝合是首选，在其他地盘。四个星期后，克氏针被拆除或被动 理疗是开始。六个星期后，病人开始活跃测距的运动练习。客观测试表明，一个满意的范围积极远端关节运动（ 50摄氏度，在漫长的手指和55 度，在食指） ，在5个月后。平均二点歧视的纸浆为12毫米，在长期的手指和11毫米，在指数手指。没有指甲畸形，冷不容忍，或牙髓萎缩有人看见。 |
2楼2007-11-26 17:30:11
3楼2007-11-27 12:41:15
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