临床病例报告:手再植

Claudia Lucía Maldonado Carrasco, Manuel Edmundo Espinoza Espinoza, Rómulo Augusto Idrovo Carrasco, Luis Alberto Tinoco Cazorla
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引用次数: 0

摘要

背景:上肢在我们的日常功能中起着至关重要的作用;对这一重要结构的伤害可能对功能、心理和社会福祉造成毁灭性后果;特别是外伤性上肢截肢是一个具有挑战性的管理和决定哪些患者将受益于肢体保留与截肢是至关重要的。病例报告:一名52岁男性患者,用工业机械在右前臂远端三分之一处进行了外伤性部分截肢,表现为尺骨和桡骨骨折,并伴有严重的软组织损伤,在缺血12小时后接受了再植手术。进展:患者术后预后良好。术后24小时,他的艾伦试验结果正常,体温正常,颜色呈粉红色,感觉减退,受伤肢体肌肉力量为2/5。术后第7天出院,随访及康复处方。13周后取下经皮针,骨折愈合。术后5个月,患者DASH评分60.83。结论:近年来再植领域日趋成熟;必须根据损伤特征、患者相关因素和功能恢复能力等几个已确定的因素,对每位患者进行断肢再植的决定。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Reporte de un caso clínico: Reimplante de mano
BACKGROUND: The upper limb plays a vital role in our daily function; injuries to this vital structure can result in devastating consequences to functional, psychological and social well-being; especially traumatic amputations of the upper limb are challenging to manage and deciding which patients would benefit from limb salvage versus amputation is critical. CASE REPORTS: A 52-year-old male patient, who suffered a traumatic partial amputation in the distal third of his right forearm with an industrial machine, presenting an ulnar and radius fracture, with severe soft tissue injuries, who underwent a replantation surgery after 12 hours of ischemia. EVOLUTION: Patient presented good postsurgical outcome. 24 hours after surgery he presented normal Allen’s test results, adequate temperature, pink coloration, hypoesthesia and 2/5 muscle strength in the injured limb. He was discharged 7 days after surgery with follow-up and rehabilitation prescription. The percutaneous needles were removed 13 weeks after, with proper bone healing of the fracture. 5 months after surgery, he presented a DASH Score of 60.83. CONCLUSION: The replantation field has become very sophisticated in recent years; the decision to perform replantation of the amputated limb must be individualized to each patient, based on several established factors such as the characteristics of the injury, patient related factors, and the functional recovery capacity.
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