| Objective:With the development of national health care and the promotion of medical treatment, the survival rate of severed finger transplantation has increased greatly. However, the excellent rate of hand function recovery is far from standard, and the transplanted fingers usually perform in low or even no function, which turns out to be a burden for the patients' future life and work. It took some observers a long period in rehabilitation practice to notice that comprehensive treatment can improve the function and capability. Moreover, in the course of rehabilitation, some factors such as age, illness, intervention time, payment manner of medical expense, etc. may have impact on treatment. To see the efficacy and confirm the influential factors, In this study, we analyzed the factors affecting the functional recovery of finger replantation in 87 patients with replantation of a finger replantation in a hospital in Shenyang. The aim of this study was to discuss how to improve the rehabilitation effect of replantation of finger. Furthermore, through analysis, this study discussed how to improve the efficacy ofre habilitation treatment, which, in turn, helps patients recover to normal and return to life and work. Method:The use of standard finger replantation and functional assessment(by 2000 in the hand surgery society of Chinese Medical Association) were assessed from 6 aspects, namely(1) motor function(2) activities of daily living(3) ADL(4) feel the recovery of blood circulation condition(5) appearance(6) recovery situation. Each have a score, the patients before treatment, rehabilitation treatment for 1 months, 2 months, 3 months were assessed, record score. Scores less than 40 points for the worse, 59 to 40 points for the poor, 60 to 79 points for good, 80 to 100 points for the best. A hospital in the Department of rehabilitation medicine in Shenyang city from 2013 to 2015 were evaluated with the acquisition of digital replantation, 87 cases, the application of EXCEL data entry, data were analyzed by SAS9.21. Using S or M(QL, QU) expressed the need for measurement data, the data used for counting rate or constituent ratio, single factor analysis use t test or chi square analysis, multiple factors non conditional Logistic regression model. Result:1.The proportion of male subjects in the study, more concentrated in the age of 21 to 50 years of age, occupational distribution to workers and farmers, mainly to the junior high school and high school education, injuries and crush injury to cut more common 68.97% of the patients had no damage to the knuckles. Not completely off the slightly more patients, accounting for 55.17%. The majority of patients did not require skin grafting, accounting for 55.17%. The fixation time was fixed at 1 to 2 months, accounting for 79.31%, and the average fixed number of days was 56.21 ± 17.60 days. The intervention time was more than 4 months, accounting for 54.02%.2.The results of univariate analysis showed that the excellent rate of functional recovery of finger replantation was related to the nature of the injury, the plane of the fracture, the condition of the injured joint, the type of finger fracture, the skin grafting, the postoperative fixation and the number of operations.3.The logistic regression analysis showed that the fingers were completely disconnected(P = 0.0008, OR = 0.217), and the injured joints(P = 0.0470, OR = 2.591) were the influencing factors of rehabilitation. Conclusion:1.Among postoperative rehabilitation patients of severed finger transplantation, the male youths outnumber the rest, and such patients, who incline to pay their medical expense by insurance, are mainly in manual labor with low level of education. The two major damage types—pressure-cutting injury and smashed-squeezing injury mainly resort to Kuntscher pin fixation, which result in long-time immobilization, thus delay the intervention time of rehabilitation.2. The rehabilitation treatment helps severed finger transplantation patients with hand function recovery. Nevertheless, the efficacy cannot reach the standard within three months featuring low excellent rate. Therefore, it concludes that patients need to prolong their rehabilitation treatment.3. The excellent rate of hand function recovery bears relationship with the following factors: the nature of injury, plane of division, damage joints, severed finger type, skin grafting(or not) and experienced surgical times.4. Complete severance of fingers and joint injury are the influential factors in the postoperative rehabilitation efficacy of severed finger transplantation. |
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