游离组织瓣移植与外固定器固定对创伤性下肢组织缺损的修复  

Repairing complex defect of skin and bone by using vascular tissue flap and external fixation in leg

作　　者：庄永青 傅小宽[1] 杜冬[1] 温桂芬 陈振鹤[1] 童静[1] 姜浩力[1] 杨怿健 

机构地区：[1]广东省深圳市人民医院,暨南大学医学院附属第二医院手显微外科,518020

出　　处：《中华显微外科杂志》2004年第3期161-163,i002,共4页Chinese Journal of Microsurgery

基　　金：广东省深圳市科研基金项目 (2 0 0 1 0 4 0 63)

摘　　要：目的　报道游离组织瓣移植在下肢修复中手术联合应用外固定器固定骨及关节的临床效果。　方法　选择下肢由于创伤造成骨、关节合并软组织、皮肤缺损等 18例患者 ,应用有血运的组织瓣移植 ,包括骨皮瓣、肌皮瓣、皮瓣移植修复下肢复合组织缺损。同时采用A O管状外固定支架或单侧多功能支架行骨外固定 ,以保持非损伤关节的活动 ,加速骨质愈合。　结果　 18例患者 ,下肢骨缺损愈合良好 ,移植皮瓣全部成活 ,术后 6～ 8个月拆除外固定器 ,下肢功能恢复满意 ,无畸形及骨不连接。　结论　应用有血运组织移植及外固定技术对下肢复合组织缺损进行修复及重建 ,具有骨折固定可靠 ,内固定简单 ,移植骨质髓腔损伤小 ,下肢功能得以早期训练的优点。Objective To report the clinical result of repairing defection in leg by using both the vascular tissue flap and external fixations. Methods The vascular tissue flap including bone flap and muscular flap to repair the complex defection (soft tissue,bones) in the leg,the ankle and the foot were applied in 18 cases. At the same time in surgery,injured bones and joints were fixed by A-O and multifunctional external fixations in order to keep the non-injured joint actively and accelerate the cure of bones. Results All 18 cases were applied successfully with the all transplanted tissue survived. Pulling about the external fixation about 6～12 months after surgery showed bone union and the function of leg recovered satisfactory. Conclusions It is a method for repairing the complex tissue defection in the leg by combining Traumatology and microsurgery technique. And it is also characterized by a minor injury in transplanted bones,early exercise for joints,flap circulation observed conveniently,and nursing easily.

关 键 词：游离组织瓣移植 外固定器 创伤 下肢组织缺损 下肢功能 

分 类 号：R658.3[医药卫生—外科学]