Surgical indications for replantation of severed fingers
1. replantation of severed fingers? Thumb is the most important function of hand, so it should be given priority in replantation and repaired as early as possible. When the severed thumb is in poor condition, the severed index finger can be replanted on the thumb, and the radial nerve and vascular bundle of the index finger can be replanted or reconstructed after transplantation. 2. Replantation of the remaining four fingers? From the functional point of view, food and middle finger are more important, and food and middle finger should be replanted if possible. Except for special occupational needs or other factors, other fingers generally do not need to be replanted. The reason is that the limitation of the range of motion of finger joints after replantation of severed fingers will affect the function of the whole hand. 3. replantation of severed limbs? It mainly means that the distal interphalangeal joint is severed by the distal finger. Because the lack of distal joint has little effect on the function of hand, replantation is not recommended, and simple in-situ suture can also have a certain survival rate. In addition to the functional needs of some special occupations and the psychological and cosmetic requirements of patients, replantation can also be tried out. 4. Replantation of fingers soaked in some liquid? The severed finger was mistakenly immersed in hypotonic, isotonic, hypertonic or some disinfectants, or improperly preserved, and then immersed in ice water after the ice melted. Due to the action of cell semipermeable membrane, low osmotic solution makes cells edema and swell, while high osmotic solution dehydrates cells. Some disinfectants, such as ethanol, potassium phenylbromide and thiomersal, directly damage vascular endothelial cells and cells of other tissues. According to the variety, concentration and soaking time, the degree of injury is different, which also has different effects on survival. If conditions permit, replantation can be tried out. 5. How to deal with the destructive injury of wrist and palm? The metacarpal part of the wrist or the distal part of the forearm was seriously damaged or cut off, but several fingers in the distal part were still intact. At this time, the crushed carpometacarpal part can be cut off, and after thorough debridement, the relatively complete fingers can be fixed on the ulna and radius respectively for replantation of the carpometacarpal part.