Clinical Study Of The Replantatian Complex Ampution Of Limb

Objective] to our hospital complex limb replantation surgery for analysis of complex limb amputation injury replantation indications, limb preservation and surgical treatment options and their survival after rehabilitation were discussed, providing reference observations, improve clinical treatment.[Methods] A retrospective analysis of clinical data from October 2009 to October 2014 in our hospital,15 patients with complex limb replantation surgery patients fully amputated limbs injury 12 cases, incomplete amputation injury three cases. All patients underwent amputation of limbs hypothermia protection.15 patients with varying degrees of skin, bone, blood vessels and other tissue defects, of which 10 cases were treated limb shortening, shortening the bones generally 3～5 cm, bone shortening in one case survived underwent lower limb amputated limb bone lengthening surgery 2 patients due to vascular defects in vascular bridge, where three cases of concomitant bone, skin, blood vessel defects, such as the implementation of composite tissue transplants, the above cases amputated limb muscle function is important to repair one, not two restorers reconstructive surgery on-line functions. For larger area of skin and soft tissue defects, bone and tendon were exposed, one of the uses closed suction wound closure, two rows flap surgery to solve the problem of tissue defect after debridement.15 cases of complex limb amputation injuries, the machine wounded eight cases, two cases of chainsaw injuries, traffic accident in four cases, Stabs one case, all successful replantation, respectively, after the first week after surgery,4 weeks-8 weeks,12 weeks 8 a correspondence between different periods established rehabilitation programs.[Results] 15 cases survived, in one case because of the lower forearm tissue grind serious setback, severe vascular injury, after fresh stump proportion of vascular anastomosis move vein 1:limb venous crisis 1,5 hours after emergency line exploratory surgery surgery see anastomosis thrombosis after surgery to clear blood clots, again consistent with postoperative survival is good. Late wound healing after surgery, reconstruction and rehabilitation after the function, followed up for 5 months to 4 years, according to Academician Chen Zhongwei limb function evaluation criteria:1), excellent:restoration of the original work; 2), good:to participate in light work; 3), poor:does not work, but it can take care of themselves; 4), bad: You can not work, can not take care of themselves. Comprehensive evaluation of upper extremity excellent three cases, good in 3 cases and poor in 1 case,5 cases of lower limb excellent, good in 3 cases.[Conclusion] The complexity of limb amputation injuries clinically more complex organizations with varying degrees of injury, disease complex, clinical work should develop individualized surgical plan based on specific conditions, which can improve the survival rate of limb replantation and limb excellent function.