Abstract
From January, 1963 to June, 1976, replantation of severed limbs and digits was performed in 438 patients at the Shanghai Sixth People's Hospital. The survival rate of replanted limbs was 83.2%, and 57.5% for replanted digits. Since 1973, the survival rate of replanted digits using microsurgery has been 92.3%. There were no postoperative deaths and few systemic complications. Local complications were responsible for failure of the replantation in 122 patients. Follow-up for more than 1 year of 214 patients showed only 3.9% with little or no functional recovery, despite survival of the replanted limb, while 34.1% were able to resume their original work with complete or nearly complete recovery of sensation. Replantation has been used successfully in severed extremities that experienced up to 36 hours of ischemia, in transpositional replantation of multiple severed digits, and with resection of the tumorbearing segment of a malignant upper extremity. In order to improve the rate of success, we believe that popularization of the replantation technique is most important.
Reśumé
Entre Janvier, 1973 et Juin, 1976, 438 malades ont eu une réimplantation de membres ou de doigts au Sixth People's Hospital de Shanghai, avec 83.2% de succès pour les membres et 57.5% pour les doigts. Depuis 1973, le pourcentage de succès pour les doigts est de 92.3%. Il n'y a pas eu de décès postopératoire et peu de complications générales. Les complications locales ont été responsables de 122 échecs. Le follow-up dépasse 1 an dans 214 cas: dans 3.9% seulement, la récupération fonctionnelle a été faible ou nulle; 34.1% ont eu une récupération sensorielle complète ou presque complète et ont pu reprendre leur travail. La réimplantation a pu être faite avec succès après durées d'ischémie allant jusqu'à 36 heures. Elle a aussi été pratiquée avec succès dans des cas de traumatismes digitaux multiples nécessitant des transpositions de doigts et dans des résections segmentaires de membre supérieur pour tumeur. Pour améliorer les résultats, nous croyons que les techniques de réimplantation doivent être popularisées.
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Chung-Wei, C., Yun-Qing, Q., Zhong-Jia, Y. et al. Extremity replantation. World J. Surg. 2, 513–521 (1978). https://doi.org/10.1007/BF01563690
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DOI: https://doi.org/10.1007/BF01563690