腓骨肌皮瓣修复桡骨长段缺损术后早期功能康复治疗  

Early functional rehabilitation after fibular myocutaneous flap repair of long radius defect

作　　者：封帆[1] 苏奕轩 王伟明[1] 王燕凤[1] 龙文浩[1] FENG Fan;SU Yixuan;WANG Weiming(Department of Hand Surgery,Dongguan Humen Hospital,Dongguan,Guangdong,523000,Chin)

机构地区：[1]东莞市虎门医院手外科,广东东莞523000

出　　处：《实用手外科杂志》2018年第2期144-146,共3页Journal of Practical Hand Surgery

基　　金：东莞市科技计划医疗卫生类科研项目(项目编号:201650715001524)

摘　　要：目的探讨吻合血管的腓骨肌皮瓣移植修复桡骨长段缺损术后功能康复治疗的方法及疗效。方法 1999年1月-2017年1月,对12例桡骨长段缺损的病例行吻合血管腓骨肌皮瓣移植修复术,术后采用适当外固定并按计划进行手部和肩关节、腕部和肘关节功能活动锻炼为主的康复治疗。定期随访,对手的外观和功能恢复情况等进行综合分析,作出疗效判断。结果随访6～36个月,12例腓骨肌皮瓣全部成活,术后10～15个月移植骨达临床愈合标准,手部肌力恢复至Ⅴ级,各关节活动度恢复至80%以上,无关节僵硬、肌腱粘连等并发症,生活可自理,可恢复正常工作。按中华医学会手外科学会上肢部分功能评定试用标准评定:优5例,良7例。结论吻合血管腓骨肌皮瓣移植修复桡骨长段缺损术后实施以适当外固定和按计划先后进行各关节功能锻炼为主的康复治疗,前臂与手功能恢复满意,临床疗效良好。Objective To investigate the method and clinical efficacy of early functional rehabilitation after vascularized fibular flap in the reconstruction of long radial defect. Methods From January 1999 to January 2017, 12 cases with long radial defect were treated with vascularized fibular flap. After operation, the proper external fixation and rehabilitation exercises were performed by hand, shoulder, wrist and elbow according to plan. Regular follow-up, the appearance and function recovery was comprehensive analyzed with opponent, and judged efficacy. Results The patients were followed up for 6-36 months, all flaps survived in 12 cases, 10-15 months after transplantation, the bone graft reached the standard of clinical healing, Hand muscle strength returned to grade V, the movement of each joint was restored to over 80%, no joint stiffness, tendon adhesion and other complications, can self-care in life and resume normal work. According to the evaluation standard of upper limb function evaluation issued by Chinese Medical Association Hand Surgery Society, 5 cases were excellent, 7 cases were good. Conclusion After vascularized fibula flap transplantation to repair long bone surgery, the proper external fixation and early functional rehabilitation can obtain satisfactory functional recovery in forearm and hand. The clinical curative effect is good.

关 键 词：桡骨 腓骨 骨缺损 肌皮瓣 功能康复 

分 类 号：R687.3[医药卫生—骨科学]