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Handchir Mikrochir Plast Chir 2005; 37(05): 337-343
DOI: 10.1055/s-2005-872848
Originalarbeit

Microsurgical Finger Replantation in Hanoi, Vietnam: Our First Experience

Mikrochirurgische Fingerreplantation in Hanoi, Vietnam: Unsere ersten Erfahrungen
Nguyen The Hoang
1   Department of Traumatology, Orthopaedics and Plastic Surgery, Central Hospital, Hanoi, Vietnam
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Zusammenfassung

In einer retrospektiven Studie berichtet der Autor über die vorläufigen Ergebnisse von Fingerreplantationen, die an der Abteilung für Unfallchirurgie, Orthopädie und Handchirurgie des Central Hospital 108, No. 1 Tran Hung Dao, Hanoi, Vietnam, zwischen September 1999 und Dezember 2002 durchgeführt wurden. 46 amputierte Finger, davon 32 komplett und 14 subtotal amputiert, wurden replantiert und nachuntersucht. Die Mehrheit der Amputationen wurde durch Quetschverletzungen (76 %) verursacht, wobei vorwiegend die linke Hand betroffen war (78,3 %). Die Erfolgsrate betrug 91,3 %. Sekundäroperationen wurden bei acht von 42 erhaltenen Fingern (19 %) durchgeführt, davon sieben Tenolysen und eine Reosteosynthese. Das funktionelle Ergebnis war in 90,5 % der Fälle als „ gut“ oder „zufriedenstellend“ einzustufen bei einer durchschnittlichen Nachbeobachtungszeit von 18 Monaten. Ein replantierter Finger musste nach einem Jahr wegen Funktionslosigkeit und Missempfindungen amputiert werden. Wir schließen aus dieser Studie, dass Fingerreplantationen, insbesondere bei multiplen Amputationen, oft erfolgreich sind und der Versuch sich stets lohnt, sowohl die Funktion als auch die normale Erscheinung von Hand und Fingern wiederherzustellen. Trotz eingeschränkter postoperativer Beweglichkeit und reduzierter Sensibilität im Vergleich zu unverletzten Fingern können die meisten Patienten mit erhaltenen replantierten Fingern nach Amputationsverletzungen aktiv und effektiv normale Tätigkeiten ohne Schmerzen oder Instabilität ausführen.

Abstract

In this retrospective study, the author reports on preliminary results of finger replantations performed in the Department of Traumatology, Orthopaedics and Hand Surgery at Central Hospital 108, No. 1 Tran Hung Dao, Hanoi, Vietnam between September 1999 and December 2002. Forty-six amputated digits involving thirty-two complete and fourteen incomplete fingers were replanted and subsequently evaluated. The majority of the amputations was caused by avulsing or crushing injuries (76 %), with the left hand being predominantly affected (78.3 %). The overall success rate of finger replantation was 91.3 %. Secondary supplemental operations were performed in 8/42 (19 %) of the surviving digits, including seven tenolyses and one repeated osteosynthesis. The combined postoperative functional outcomes rated either as “good” or “fair” were 90.5 %, based on an average follow-up period of 18 months. One surviving replant was amputated one year later due to lost function and paraesthesia. We concluded from the study that digit replantations, especially multiple amputations, are often successful and it is always worthwhile to attempt to restore function as well as the normal appearance of the hand and digits. Despite the limited postoperative movement and less than normal level of sensation compared to uninjured counterparts, most individuals with surviving replanted digits following amputations can actively and effectively perform normal tasks without instability or pain.

Schlüsselwörter

Fingeramputation - Replantation

Key words

Digit amputations - replantation


Publication History

Received: 18 May 2004

Accepted: 20 July 2005

Publication Date:
14 November 2005 (online)

© 2005. Thieme. All rights reserved.

Georg Thieme Verlag KG Stuttgart · New York
Stuttgart

 

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