最新断肢(指)再植.pptVIP

本文档共35页；当前第1页；编辑于星期日\16点21分 陈中伟：王存柏病例 In January second,1963， Machine cut January, cold weather Amputated part wrapped in towel Reach hospital within 1 hour 本文档共35页；当前第2页；编辑于星期日\16点21分 But, this time….. 本文档共35页；当前第3页；编辑于星期日\16点21分 World First Hand Replantation 本文档共35页；当前第4页；编辑于星期日\16点21分 Do you like this lesson? Do you want to be a surgeon as Chen Zhongwei? 本文档共35页；当前第5页；编辑于星期日\16点21分 Learning Outline Definition and History 定义和历史 Classification 分类 Anatomy 解剖 Amputated parts storage and transportation 断指的保存和早期处理 Indications ?适应症 Surgical technique in sequence 再植手术顺序 Post-operative care 术后处理 本文档共35页；当前第6页；编辑于星期日\16点21分 Definition The surgical reattachment of a limb / digit, that has been completely cut from a persons body, restore the blood circulation, so that limb / digit to get the survival and recovery. 将完全离断的四肢/手指重新接上，恢复其血液循环，使断肢/指得到存活和恢复功能的手术。 本文档共35页；当前第7页；编辑于星期日\16点21分 H?fner 1903 Animal survival Jacobson Suarez 1960 Small vessel 屠开元 1960 Dog Replantation Malt 1962.5 Arm 陈中伟 1963.1 Hand Komatsu Tamai 1965 Fingers 陈中伟 1966 Fingers History 本文档共35页；当前第8页；编辑于星期日\16点21分 Classcification regular cut and Ring Avulsion Finger tip amputation Anatomy After surgery Good bone union Ring Avulsion Amputation 脱套伤 After surgery 本文档共35页；当前第9页；编辑于星期日\16点21分 Classcification: one or multiple fingers Pre-OP Later post-OP Post-OP 本文档共35页；当前第10页；编辑于星期日\16点21分 Classcification: Forearm amputation Pre-OP Later post-OP 本文档共35页；当前第11页；编辑于星期日\16点21分 Classcification: Upper arm amputation Pre-OP Post-OP Later post-OP 本文档共35页；当前第12页；编辑于星期日\16点21分 Anatomy of Digits The fingers are supplied by vessels and nerves which run up the lateral aspects of each digit. 本文档共35页；当前第13页；编辑于星期日\16点21分 Hand Anatomy Because of junctura(肌腱联合), a complete tendon laceration proximal to the junctura may still result in normal extensor function. The flexor tendons are enclosed in synovial sheaths （滑液鞘） making them easy to deep space infections 本