腳趾移植重建手部功能之復健成效：問卷調查報告

Functional Outcome in Digital Reconstruction with Toe Transfer: Preliminary Report

劉耀宗(Yiu-Chung Lau) ； 黃美涓(May-Kuen Wong) ； 魏福全(Fu-Chan Wei) ； 吳鑫漢(Shin-Han Wu)

《中華民國復健醫學會雜誌》 16期 (1988/12) Pp. 27-34

摘要

本研究是收集從民國73年1月至76年1月，在林口長庚醫院接受腳趾移植到手指並復健治療的54位住院病人為問卷調查對象所做追蹤分析報告。追蹤時間由7個月到3年不等。以問卷方式探討病人手術後工作上使用的情形及滿意度，共34位病人回覆(63.9%)。
手術後改變慣用手者13人。個人及社會接受程度以能接受者居多，分別為85.9%及76.5%。
手部功能方面，大拇指經手術移植者，在微調手錶及拿一根針上，相當高比例的病人都呈現困難，在提重物、拿鑰匙，病人呈現困難者佔一半。而其它指頭經手術移植者呈現困難率較前者為低。
感覺方面，能分辨物件為尖銳或鈍者佔76.5%。在新指疼痛感方面，絕大部分病人平時不痛共有21位(61.8%)，運用時感到輕微痛者有17位(50.8%)。
手術後常使用重建手者為20位，而病人需改變職業者為25位(73.5%)。

並列摘要

The functional outcome of 34 cases of digital ampution with toe-to-digit reconstruction in Chang-Gung Memorial hospital, from Jan 1984 to Jan 1987, were evaluated by questionaires.
The age of the patients were from 16 to 48 years old, with male in majority (82.3%). Nearly all of them were occupational injury. There were 20 cases with right hand injury, most of them should change hand dominance even after reconstruction surgery (63.2%).
In the patients having single thumb loss, whether the reconstruction surgery was used by big toe or second toe, there were no difference in functional deficits of precision pinch (85.7%) and object grasp (71.4%).
As for the sensation of the new digit, 76.5% cases had hypesthesia, while 11.8% presented with severe cold intolerance.
Most of the patients usually used their reconstruction hand during working (58.8%), but should change to easier job (73.5%).
The self acceptance and social acceptance were 85.9% and 76.5% without sex difference.
The improvement or functional outcome will be expected by better surgical procedures, rehabilitation programs and psychosocial supports.

並列關鍵字

digital amputation ； reconstruction ； toe transfer ； rehabilitation