腓骨横向骨搬移微血管网再生术治疗糖尿病足  

A case of diabetic foot treated with fibula transversal bone transfer and micro-vascular network regeneration

作　　者：王斌[1] 宫中平[1] 刘英杰[1] 朱明东 蒋文平[1] 刘伟[1] 吕梓宸 Wang Bin;Gong Zhongping;Liu Yingjie;Zhu Mingdong;Jiang Wenping;Liu Wei;Lil Ziehen(Hand Surgery Department,Reconstructive Surgery,Lower Extremity Vascular Disease Department,the Second Hospital of Tangshan(Orthopedic Hospital Affiliated to North China University of Science and Technology),Tangshan 063000,China)

机构地区：[1]唐山市第二医院(华北理工大学附属骨科医院)手外科、修复重建外科、下肢血管病科,唐山063000

出　　处：《中华医学杂志》2020年第9期710-712,共3页National Medical Journal of China

摘　　要：报道1例出现右足趾肿痛、破溃4年,加重1个月的糖尿病足患者,经严格内科治疗及相关检查后,拟行胫骨横向骨搬移,但术前发现小腿内侧皮肤条件欠佳,遂行腓骨横向骨搬移。用微型截骨器在腓骨外侧中段两侧截骨,两截骨线相距约10 cm,远端截骨线距外踝尖约10 cm。术后第8天开始骨搬移,每6小时搬移1次,每天向内侧延长1 mm,搬移14 d后再往回搬移14 d。从术前术后皮温、踝肱指数、CT血管造影、CT值、疼痛视觉模拟评分(VAS)及创面愈合情况等进行对比评估。术后28 d创面完全愈合。Reports a case of diabetic foot patient with right toe pain,ulceration for 4 years and aggravation for 1 month.After rigorous medical treatment and related examinations,transeversal bone transfer of tibia was proposed.However,the skin condition on the inner side of the lower leg was not good before the operation,so the transversal bone removal of the fibula was performed.Two segments of the lateral fibula were osteotomized with miniature osteotomies.The two osteotomy lines were about 10 cm apart.The distal osteotomy line is about 10 cm from the tip of the lateral malleolus.On the 8th day after the surgery,the bone was moved every 6 hours and was extended inwards by 1 mm every day.After 14 days,the bone was moved back for another 14 days.Skin temperature from preoperative to postoperative,ankle brachial index,CT angiography,CT value,visual analogue scale(VAS)of pain and wound healing were evaluated by comparison.The wound was completely healed 28 days after the operation.

关 键 词：腓骨 骨搬移 糖尿病足 血管再生 

分 类 号：R687[医药卫生—骨科学] R587[医药卫生—外科学]