皮瓣移植结合外固定架治疗小腿复合组织损伤35例效果观察  

Skin Flap Transplantation with External Fixation Apparatus in Treating 35 Patients with Compound Tissue Damage of the Shank

作　　者：施洪臣[1] 章雪松[1] 李宝山[1] 

机构地区：[1]解放军285医院手足外科北京军区手外科研究诊疗中心,河北邯郸056001

出　　处：《临床误诊误治》2012年第6期80-82,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨皮瓣移植结合外固定架治疗小腿复合组织损伤的效果。方法对我院2005年2月—2010年8月胫骨骨折、骨缺损同时伴小腿皮肤、软组织缺损或感染、坏死的35例,采用游离皮瓣、腓肠神经营养皮瓣或小腿局部转移皮瓣加外固定架固定的方法进行治疗。结果本组32例皮瓣全部成活,创面一期愈合;3例皮瓣部分坏死,经换药、植皮后愈合。按照Edwards评价系统功能评定:优22例,良10例,可3例,优良率91.4%。本组32例获随访6～18个月,平均13个月,骨折均愈合,其中3例3个月后骨痂生长缓慢,予调整外固定架加压固定,并嘱患者适当负重锻炼,18个月时骨折愈合好。结论外固定架固定联合皮瓣移植是治疗小腿骨损伤伴皮肤软组织缺损的一种较好方法。Objective To explore the effect of treatment of skin flap transplantation with external fixation apparatus in treating compound tissue damage of the shank. Methods 35 patients with tibial fractures, bone defection accompanied with infection of leg skin and soft tissues admitted during February 2005 and August 2010 were treated using a flap （free skin flap, sural neurocutaneous island flap or local grafting flap） plus external fixation. Results Skin flaps in 32 cases survived, and wound surface primarily healed. Partial necrosis flaps occurred in 3 cases and healed after dermatoplasty. Edwards evaluation system indicated that the results were excellence in 22 cases, good in 10 and common in 3. The excellence rate was 91.4%. 32 cases were followed up for 6-18 months, fractures healed in 13 months averagely, bony callus of 3 cases were stunt and the fractures healed in 18 months using external fixation apparatus and after appropriate weight-bearing exercises. Conclusion Skin flap transplantation with external fixation apparatus is effective in treating the compound tissue damage of the shank.

关 键 词：复合性软组织损伤 小腿骨损伤 外科皮瓣 外固定器 

分 类 号：R687.3[医药卫生—骨科学]