腓骨复合组织瓣移植修复前臂骨与软组织缺损  

Transplantation of fibula composite tissue flap to the repair of forearm bone and soft tissue serious defect

作　　者：黄伟雄[1] 王明月[1] 杨月丽 邹新龙[1] 王瑞雪[1] 刘存林[1] 

机构地区：[1]武警辽宁总队医院手足显微外科,沈阳110034

出　　处：《中华显微外科杂志》2013年第3期237-240,共4页Chinese Journal of Microsurgery

摘　　要：目的探讨游离腓骨复合组织瓣移植修复前臂骨与软组织重度缺损的效果。方法自2004年3月至2011年2月，采用游离腓骨复合组织瓣移植治疗前臂骨与软组织重度缺损11例，移植复合组织瓣腓骨长度8～14cm，皮瓣面积5cm×8cm～20cm×20cm。术后3、6、12个月观察骨折愈合情况，1年后评定伤肢功能。结果11例腓骨复合组织瓣全部成活，术后随访12个月以上，3个月即可见骨折端已有愈合征象，半年即可见腓骨与前臂骨折愈合良好，术后1年按Enneking系统评分平均22．9分；前臂旋转功能：优3例，良6例，差2例；2例腓肠神经桥接移植中，1例修复桡神经虎口静态两点辨别觉（s2PD）9mm，1例修复尺神经小指末节掌侧s2PD15mm，所有病例拇指握拳、拇指与其他4指对指均可，供区踝关节活动正常。结论游离腓骨复合组织瓣是修复前臂骨与软组织重度缺损的一种理想的手术方法。Objective To investigate the effect of free transplantation of fibula composite tissue flap to the repair of forearm bone and soft tissue serious defect. Methods Eleven cases of reparing forearm bone and soft tissue serious defect through transplantation of free fibula composite tissue petal were applied from March 2004 to February 2011. The length of transplanted fibula composite tissue flap was 8-14 cm; the flap area was 5 cm × 8 cm-20 cm ×20 cm. The curing situation on bone fracture was observed in 3, 6 and 12 months after the surgical opration and the function of defected arm was evaluated in 1 year after surgical operation. Results All of 11 cases of fibula composite tissue flap were survived. The observation was undertaken for more than 12 months after the operation and the fracture section occured the characteristics of healing up in 3 months and fibula and arm bone occured well healed up in half a year; It scored 22. 9 according to Enneking system after 1 year of the operation. The function of forearm rotation were classed as this： 3 good cases, 6 medium cases and 2 poor cases. In the 2 sural nerve bridging transplantation cases, one case was repaired of radial nerve inside static＇s two-point discrimination （s2PD） to 9 mm, another case was repaired of ulnar nerve distal volar little finger s2PD to 15 mm. All the cases could achieve making a fist with thumb and a thumb could be oppoiste to other 4 fingers, and the ankle joint movement was normal. Conclusion Transplantion of free fibula composite tissue flap to the repair of forearm bone and soft tissue serious defect is an ideal surgical operation method.

关 键 词：前臂 腓骨瓣 移植 显微外科 

分 类 号：R65[医药卫生—外科学]