CLINICAL EXPERIENCE OF RETROGRADE REPLANTATION FOR AMPUTATED TOE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CHENGHeyun ,  JUJihui , ZHAOQiang , SHIZhihua , LIXiangjun , HUMiao , DUWeiwei

Department of Hand Surgery, Ruihua Affiliated Hospital of Soochow University, Suzhou Jiangsu, 215104, P. R. China;

Corresponding?author：

JUJihui, Email: jjh2006@263.net

Keywords：

Toe; Isolated injury; Amputation replantation; Retrograde

DOI：

10.7507/1002-1892.20160112

Video：

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Objective To summarize the clinical experience of the retrograde replantation for amputated toe. Methods Between January 2010 and August 2015, 11 cases of amputated toes (15 toes) were treated by the retrograde replantation. All patients were male, with a mean age of 31 years (range, 18-45 years). The causes included cutting injury in 6 cases (9 toes) and crush injury in 5 cases (6 toes). One case had amputated great toe and distal segment of the second toe combined with the third toe nail bed contusion; 1 case had amputated proximal great toe and middle segment of the second and third toes; 1 case had amputated proximal segment of great toe and middle segment of the second toe; 7 cases had amputated distal segment of the great toe; and 1 case had amputated middle segment of the fifth toe. The time from injury to hospital was 1-3 hours (mean, 2 hours). Results Thirteen toes survived completely after operation. Toe necrosis occurred in 1 toe; partial dorsal skins necrosis and nail bed necrosis occurred in 1 toe, and was cure after repaired with dorsalis pedis island flap. The rate of success for replantation of amputated toes was 93.33% (14/15). X-ray examination showed fracture healing of all survival toes at 8-12 weeks after operation (mean, 10 weeks); internal fixation was removed. Eleven cases were followed up 3-12 months (mean, 7.5 months). The survival toes had good appearance and toenail. The two point discrimination was 9-12 mm (mean, 10 mm) at last follow-up. The patients could walk and run normally. Conclusion It is an ideal surgical method to use retrograde replantation to treat amputated toe, with the advantages of simple operation and high survival rate.

Citation： CHENGHeyun, JUJihui, ZHAOQiang, SHIZhihua, LIXiangjun, HUMiao, DUWeiwei. CLINICAL EXPERIENCE OF RETROGRADE REPLANTATION FOR AMPUTATED TOE. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(5): 555-557. doi: 10.7507/1002-1892.20160112 Copy

1.	?謝昌平, 陳朝輝, 馬運剛, 等. 改變體位提高斷趾再植成功率的臨床研究. 中華創傷骨科雜志, 2005, 7(4):338-340.
2.	田萬成, 潘風雨, 盧全忠, 等. 逆行法斷指再植臨床應用體會. 中華顯微外科雜志, 2008, 31(6):456-458.
3.	張賢龍, 劉兆青, 鐵江輝. 經趾底足部不全離斷逆行法再植術成功 1例. 實用手外科雜志, 2008, 22(4):231.
4.	李連楚. 特殊組織器官完全離斷的顯微再植. 實用手外科雜志, 2014, 28(3):294-297.
5.	陳德武, 郝鵬, 李蘇皖, 等. 足趾及足斷離再植63例. 中華顯微外科雜志, 2000, 23(2):148-149.
6.	李連楚, 陳堅, 王增濤. 右足五趾完全離斷再植成功一例. 中華顯微外科雜志, 2008, 31(6):404.
7.	儲國平, 呂國忠, 趙慶國, 等. 足拇趾離斷再植及踝前穿支皮瓣修復成功一例. 中華整形外科雜志, 2011, 27(6):471-472.
8.	彭艷斌, 萬圣祥, 肖穎鋒, 等. 膝關節屈曲90°下肢平置順行法再植拇趾. 臨床和實驗醫學雜志, 2011, 10(3):184-185.
9.	曾明燦, 曹俊杰, 邱慶明, 等. 足趾離斷再植17例. 中華顯微外科雜志, 2003, 26(2):143-144.
10.	謝揚, 楊揚震, 吳道彬, 等. 足趾離斷再植60例. 中華顯微外科雜志, 2004, 27(2):111-112.
11.	韋酋亨. 足趾離斷再植80例. 實用手外科雜志, 2007, 21(1):51-52.
12.	陳光, 施海峰, 芮永軍, 等. 小兒足趾離斷再植手術體會. 中國骨與關節損傷雜志, 2012, 27(10):953-954.
13.	李連楚, 周國偉, 李迎軍, 等. 足趾多趾完全離斷再植的臨床體會. 中華顯微外科雜志, 2010, 33(1):70-71.
14.	姜曉華, 楊天昀, 劉思法. 趾旋轉撕脫性離斷再植11例. 實用手外科雜志, 2010, 24(12):312-313.
15.	隋海明, 叢海波, 王晨霖, 等. 趾撕脫性離斷再植. 中華顯微外科雜志, 2003, 26(4):302-303.
16.	臧成五, 趙睿, 張航, 等. 不同術式在指尖再植中的臨床應用. 中華手外科雜志, 2013, 29(3):185-186.
17.	潘維亮, 張峰, 徐傳剛, 等. 順行法和逆行法在含拇指或足趾斷指 (趾)再植中的對比研究. 中國臨床實用醫學, 2010, 4(12):34-36.
18.	周明武, 李坤德, 趙東升, 等. 靜脈動脈化在手指再植與再造中的應用. 中華手外科雜志, 2006, 22(2):101-102.

1. ?謝昌平, 陳朝輝, 馬運剛, 等. 改變體位提高斷趾再植成功率的臨床研究. 中華創傷骨科雜志, 2005, 7(4):338-340.
2. 田萬成, 潘風雨, 盧全忠, 等. 逆行法斷指再植臨床應用體會. 中華顯微外科雜志, 2008, 31(6):456-458.
3. 張賢龍, 劉兆青, 鐵江輝. 經趾底足部不全離斷逆行法再植術成功 1例. 實用手外科雜志, 2008, 22(4):231.
4. 李連楚. 特殊組織器官完全離斷的顯微再植. 實用手外科雜志, 2014, 28(3):294-297.
5. 陳德武, 郝鵬, 李蘇皖, 等. 足趾及足斷離再植63例. 中華顯微外科雜志, 2000, 23(2):148-149.
6. 李連楚, 陳堅, 王增濤. 右足五趾完全離斷再植成功一例. 中華顯微外科雜志, 2008, 31(6):404.
7. 儲國平, 呂國忠, 趙慶國, 等. 足拇趾離斷再植及踝前穿支皮瓣修復成功一例. 中華整形外科雜志, 2011, 27(6):471-472.
8. 彭艷斌, 萬圣祥, 肖穎鋒, 等. 膝關節屈曲90°下肢平置順行法再植拇趾. 臨床和實驗醫學雜志, 2011, 10(3):184-185.
9. 曾明燦, 曹俊杰, 邱慶明, 等. 足趾離斷再植17例. 中華顯微外科雜志, 2003, 26(2):143-144.
10. 謝揚, 楊揚震, 吳道彬, 等. 足趾離斷再植60例. 中華顯微外科雜志, 2004, 27(2):111-112.
11. 韋酋亨. 足趾離斷再植80例. 實用手外科雜志, 2007, 21(1):51-52.
12. 陳光, 施海峰, 芮永軍, 等. 小兒足趾離斷再植手術體會. 中國骨與關節損傷雜志, 2012, 27(10):953-954.
13. 李連楚, 周國偉, 李迎軍, 等. 足趾多趾完全離斷再植的臨床體會. 中華顯微外科雜志, 2010, 33(1):70-71.
14. 姜曉華, 楊天昀, 劉思法. 趾旋轉撕脫性離斷再植11例. 實用手外科雜志, 2010, 24(12):312-313.
15. 隋海明, 叢海波, 王晨霖, 等. 趾撕脫性離斷再植. 中華顯微外科雜志, 2003, 26(4):302-303.
16. 臧成五, 趙睿, 張航, 等. 不同術式在指尖再植中的臨床應用. 中華手外科雜志, 2013, 29(3):185-186.
17. 潘維亮, 張峰, 徐傳剛, 等. 順行法和逆行法在含拇指或足趾斷指 (趾)再植中的對比研究. 中國臨床實用醫學, 2010, 4(12):34-36.
18. 周明武, 李坤德, 趙東升, 等. 靜脈動脈化在手指再植與再造中的應用. 中華手外科雜志, 2006, 22(2):101-102.

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Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL EXPERIENCE OF RETROGRADE REPLANTATION FOR AMPUTATED TOE

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