无肝素指骨远端再植功能结果的回顾性分析

Q3 Medicine

Journal of Hand Surgery Global Online Pub Date : 2025-03-01 DOI:10.1016/j.jhsg.2024.02.018

N. Jithendran MS, MCh , J. Terrence Jose Jerome FRCS(G), European Diploma Hand Surgery

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引用次数: 0

摘要

目的本研究回顾了无肝素的远端指尖再植，旨在评估其功能结果。方法回顾性分析2016-2023年在两家专业手外科中心接受远端指尖再植手术的患者。分析患者人口统计学、损伤机制、缺血时间、并发症和功能结局。使用指尖损伤结局评分评估功能结果。结果30例患者在研究期间行了不使用肝素的指尖再植术。平均年龄31岁（8 ~ 56岁）。机器割伤撕脱伤（23例）最为常见。平均缺血时间7.4小时。25个远端再植存活。指尖损伤结局评分将结果分为优（n = 10）、好（n = 10）、一般（n = 5）和差（n = 5）。并发症包括缩短（n = 5）、指甲营养不良（n = 1）和不耐冷（n = 1）。结论本研究提示不使用肝素的远端指尖再植具有良好的功能结局。没有观察到明显的并发症，提示肝素可能不是所有病例都需要的。肝素在指尖再植中的应用需要进一步的研究。研究类型/证据水平治疗性IV。

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Retrospective Analysis of Functional Outcome of Distal Fingertip Replants Without Heparin

Purpose

This study reviews distal fingertip replants without heparin, aiming to assess their functional outcomes.

Methods

This retrospective study reviewed all patients who underwent distal fingertip replants in two specialized hand surgery center over 7 years (2016–2023). Patient demographics, injury mechanism, ischemia time, complications, and functional outcomes were analyzed. The functional outcomes were assessed using the Fingertip Injuries Outcome Score.

Results

A total of 30 patients underwent distal fingertip replantation without heparin during the study period. The mean age was 31 years (range, 8–56 years). Machine cut avulsion (23 cases) was the common injury. The mean ischemia time was 7.4 hours. Twenty-five distal replants survived. Fingertip Injuries Outcome Scores categorized outcomes as excellent (n = 10), good (n = 10), fair (n = 5), and poor (n = 5). Complications included shortening (n = 5), nail dystrophy (n = 1), and cold intolerance (n = 1).

Conclusion

This study suggests favorable functional outcomes for distal fingertip replants without heparin. No significant complications were observed, suggesting that heparin may not be necessary for all cases. Further research is needed for more explicit guidelines on heparin use in fingertip replantation.