The Experimental Study of the Venous Drainage through theBone Marrow at Replantation of the Amputated Digits and free tissue transfer.

静脉引流是断指再植成功的重要因素，尤其是远端指节段的静脉引流。然而，静脉引流不能总是重建，因为静脉没有搜索，太小而无法缝合等。在这项研究中，通过骨髓的静脉引流似乎是有用的和重要的，而新的皮下静脉。用激光多普勒血流仪观察断肢的皮肤颜色和血流量。进行了骨髓染色注射研究和放射性同位素灌注研究。具有连续性的骨髓组基本存活。提示骨髓在静脉引流中起重要作用。我们有许多临床病例在远端指骨水平切除再植指骨，并有几例成功的病例没有静脉重建。大多数患者切除了远端指骨关节软骨，仅用一根直丝固定两根指骨，再植时损伤最小。关于骨髓在静脉引流系统中的作用，文献报道不多，但尚无实验研究的报道。提示骨髓在静脉引流中具有重要的作用，特别是在术后即刻和早期，直至皮下静脉引流系统再生。

Venous drainage is an important factor for the success of the replantation of the amputated digits, especially at the level of distal phalanx. However, venous drainage cannot be always reconstructed, because the vein is not searched and is too small to suture etc. In this study, the venous drainage through the bone marrow is seemed to be useful and significant while the new subcutaneous vein.The amputated limbs are observed skin color and the blood flow of them are measured with a laser Doppler flow meter. Dye injection study and radioisotope perfusion study of the bone marrow are perfomed. The groups of the bone marrow with continuity are almost survival. It is suggested that the bone marrow is imporatant for the venous drainage. We have had many clinical cases which been replanted digits amputated at the distal phalanx level and have experienced several successful cases without venous reconstruction. Most of them were excised the distal phalangeal joint cartilage and both of the phalangeal bones were fixed using only single sraight wire with the least damage possible at replantation.There are a few reports which are described significance of the bone marrow for the venous drainage sysytem and there is no report which is investigated experimentally. It was suggested that the bone marrow was imporatant for the venous drainage, especially at the immediately-phase and early-phase after operation until the regeneration of the subcutaneous venous drainage system.