Ten-digit replantation with seven years follow-up: A case report.

In this report, we present a case of successful replantation of 10-digit complete amputation and results of postoperative rehabilitation in 7 years follow-up. The rehabilitation program included psychotherapy, physical therapy, sensory re-education, and measurements. At the 7 years postoperatively, the static two-point discriminations of replanted digits ranged from 4 to 11 mm. Grasping powers ranged from 69 to 81 lb, and pinching powers ranged from 13 to 19 lb. The patient returned to the previous employment. Our experience has demonstrated that systemic postoperative rehabilitation and measurements could achieve satisfactory recovery of the sensory and motor functions of multiple-digit replantation.

[Clinical diagnosis and treatment of superior tibial fracture complicating with crotch injury of distal popliteal artery].

OBJECTIVE: To investigate the clinical effects of treatment for superior tibial fracture complicating with crotch injury of distal popliteal artery by an alternative micro-surgical operation. METHODS: During Feb. 2002 to Oct. 2007, there were 19 patients with superior tibial fracture complicating with crotch injury of distal popliteal artery included 15 males and 4 females aged from 21 to 48 years (means 35 years). There were 6 cases complicating with fracture of tibial plateau, 3 cases complicating with nerve injury. The tibial fracture were fixed with external fixator and the anterior tibial artery and vein and posterior tibial artery and vein were treated by transplantable great saphenous vein (Y-shape) combined with windowing for interosseous membrane by the posterior and anterolateral incision. Evaluations of clinical effect were performed according to Rasmussen functional score system. RESULTS: All patients survived after operation. All fracture achieved bony union, the union time was from 3 to 14 months (means 5.5 months). All patients were followed-up for from 8 to 23 months (means 13 months). The mean Rasmussen functional score was (27.0 + 2.9). The results were excellent in 11 cases, good in 7, and fair in 1. CONCLUSION: The surgical exploration should be done as soon as possible when diagnosis of injuries of large arteries is definite or highly suspected. Simultaneous reconstruction of both posterior tibial artery and anterior tibial artery associated with vein can reduce the rate of disability and recover function of limb.