带蒂胫骨皮瓣移植修复小腿创伤性感染性骨和软组织缺损  

Repairation of bone and skin defect in leg with vascularized tibial bone-skin flap graft

作　　者：唐洪涛[1] 李采宁[2] 王冲[3] 程真真[1] 程春生[1] 

机构地区：[1]河南省洛阳正骨医院河南省骨科医院髋关节二科,河南省洛阳市471002 [2]安徽省庐江县中医院骨科 [3]安徽省滁州市中西医结合医院骨科

出　　处：《中华显微外科杂志》2015年第5期428-431,共4页Chinese Journal of Microsurgery

摘　　要：目的 探讨应用带蒂胫骨皮瓣移植修复小腿严重的创伤性感染性骨和软组织缺损的临床疗效. 方法 白2007年8月至2013年11月,对27例小腿创伤性感染性骨与皮肤软组织缺损采用带蒂胫骨皮瓣移植治疗,重建患肢胫骨连续性及覆盖创面.本组年龄21 ～ 54岁,平均33岁;皮肤软组织缺损5.0cm× 8.5 cm ～ 7.4 cm× 16.0 cm,骨缺损长度5.0 ～ 16.0 cm.胫骨皮瓣面积最小6.0 cm×10.0 cm,最大10.0 cm× 18.0 cm,骨瓣最长为18.0 cm. 结果 1例皮瓣因血液循环障碍出现部分坏死,断蒂时行临近皮瓣推进修复,其余26例皮瓣完全成活,经6个月～4年的随访,患肢感染得到完全控制,功能及外形恢复良好.结论 带蒂胫骨皮瓣血供丰富、皮瓣面积大、骨瓣长度长,可一次性修复小腿长段骨及大面积软组织缺损,完成骨结构重建及创面覆盖,缩短病程,利于患肢功能尽快恢复.Objective To explore the outcome of the tibial bone-skin flap grafts in the management of severe traumatic osteomyelitis complicated with bone and skin defect in leg.Methods Twenty-seven cases of the traumatic osteomyelitis complicated with bone and skin defect in leg were treated with vascularized tibial bone-skin flap grafe from August, 2007 to November, 2013.Reconstruction of limb tibia continuity and cover the wound.Results The tibial bone-skin flaps were completely survived in 26 of the 27 cases except 1 ease which was repaired by adjacent flap because of the disorder blood circulation.The followed-up showed that all flaps had good blood circulation.The infection was controlled completely.The leg function and contour were satisfactory.Conclusion The tibial boneskin flap has the advantages of abundant blood supply, full bone-skin flap supply, shortens hospitalization and suitable for treatment of traumatic osteomyelitis complicated with bone and skin defect in leg.

关 键 词：带蒂胫骨皮瓣 骨皮软组织缺损 小腿 移植 

分 类 号：R658.3[医药卫生—外科学]