应用皮瓣转位修复四肢骨折伴软组织缺损创面  

Application of Flap Translocation Repair in the Treatment of Limb Fractures with Soft Tissue Defects

作　　者：张军 陈万军 刘晓雪 ZHANG Jun;CHEN Wan-jun;LIU Xiao-xue(Department of Orthopedics,Xiangzhou District People's Hospital,Xiangyang 441000,Hubei,China;Department of Plastic Surgery,Xiangzhou District People's Hospital,Xiangyang 441000,Hubei,China)

机构地区：[1]襄阳市襄州区人民医院骨科,湖北襄阳441000 [2]襄阳市襄州区人民医院整形美容科,湖北襄阳441000

出　　处：《中国美容医学》2018年第1期33-36,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:研究皮瓣转位修复对四肢骨折伴软组织缺损患者的应用效果。方法:对本院收治的120例四肢骨折伴软组织缺损患者行常规对症治疗、骨折内固定术,根据缺损类型选择不同的皮瓣转位修复,观察术后恢复情况。结果:术后4d,有2例出现皮瓣水肿,1例出现局部张力性水疱,治疗后痊愈,皮瓣存活率为100%。术后10d,皮瓣肿胀Ⅰ度者91例,肿胀Ⅱ度者19例,肿胀Ⅲ度者10例,无肿胀Ⅳ度者。患者术后10d全血粘度、血浆粘度、红细胞变形指数和红细胞聚集指数均明显低于术前,差异有统计学意义(P<0.05)。术后随访1年,皮瓣均全部存活,色泽、外形较好,患者对皮瓣美容修复效果均较满意,总体满意率为82.50%(99/120),术后平均住院时间为(19.46±5.27)d;关节功能评分显著优于术前,差异有统计学意义(P<0.05)。结论:皮瓣转位修复治疗四肢骨折伴软组织缺损患者的效果显著,皮瓣存活率高,术后恢复较快,创面美容效果较好。Objective To study the application effects of flap translocation repair on limb fractures with soft tissue defects.Methods 120 cases of patients with limb fractures and soft tissue defects treated in our hospital were given the routine symptomatic treatment,and fracture internal fixation.The choice of different flaps according to the type of defect,and the postoperative flap conditions were observed.Results At 4d after operation,there were 2 cases of flap edema and one case of local tension blister,and they were healed with the flap survival rate of 100%after dressing and other treatment.At 10d after operation,there were 91 cases of swelling of the skin flap,19 cases with swelling II degree,10 cases with swelling degree of grade III,and no swelling IV degree in the skin flap.The whole blood viscosity,plasma viscosity,erythrocyte deformability index and erythrocyte aggregation index of 10d were significantly lower than those before operation,and the difference was statistically significant(P<0.05).Follow-up for 1 year,all skin flaps survived,color and shape of flaps were better.The patients were satisfied with the effect of skin flap cosmetic repair,and the total satisfaction rate was 82.50%.The average hospitalization time after operation was(19.46±5.27)d.The score of joint function was significantly better than that before operation,and the difference was statistically significant(P<0.05).Conclusion Flap translocation repair for patients with limb fractures and soft tissue defects can have significant effects with high flap survival rate,fast postoperative recovery and good wound cosmetic effect.

关 键 词：四肢骨折 软组织缺损 皮瓣 修复 

分 类 号：R622[医药卫生—整形外科]