组合式外固定架联合组织瓣移位治疗下肢感染性骨外露  

Composite External Fixation Combined with Flap Transposition in the Treatment of Lower Limb Infected Bone Exposure

作　　者：鲁波勇 祝少博[2] 吴刚[2] 张韬[2] 

机构地区：[1]湖北省宜昌市第三医院骨科,湖北宜昌433003 [2]武汉大学中南医院骨科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2011年第5期649-651,共3页Medical Journal of Wuhan University

摘　　要：目的:探讨外固定支架联合组织瓣移位治疗下肢感染性骨外露的临床疗效。方法:本组27例患者,因外伤及继发于内固定术后的感染造成感染性骨外露,软组织缺损范围(3-7)cm×(6-17)cm,采用外固定架固定,依据不同的病情分别选用肌瓣、皮神经营养血管皮瓣和穿支皮瓣局部移位及不同类型的交腿皮瓣移位加以修复。结果:本组27例患者,2例患者术后形成窦道,1例患者行腓肠肌内侧头肌瓣移位术后肌瓣坏死,二期行交腿皮瓣移位术。其余病例组织瓣移位术后组织瓣均成活,无1例坏死。局部炎症得到控制,骨外露得到良好覆盖。结论:外固定架联合组织瓣移位是治疗下肢感染性骨外露的较好的方法之一。Objective：To evaluate the effect of external fixation combined with flap transposition in infected bone exposure.Methods：Twenty-seven cases with infected bone exposure caused by injury or infection after internal implant were retrospective studied,and the tissue defect size ranged（3-7） cm×（6-17） cm.External fixation was used to stabilize fracture,and different flaps,such as muscular flaps,neurocutaneous vascular flaps,perforator flaps and cross leg flaps,were chosen to treat tissue defects.Results：Two of the 27 cases had the complication of sinus after operation,including one case with flap necrosis after treated with medial head gastrocnemius muscle flap.Both cases were treated by cross leg flaps finally.The other flaps were survived and no necrosis occurred.Local inflammation was controlled and bone exposure and tissue defect were healed.Conclusion：External fixation combined with flap transposition was an appropriate approach to treat infected bone exposure of lower limb.

关 键 词：外固定支架 感染性骨外露 组织瓣移位术 

分 类 号：R681.8[医药卫生—骨科学]