小腿骨搬移中软组织嵌顿的Z字成形术  

Z-plasty for soft tissue incarceration during bone transport of the tibia

作　　者：董惠双[1] 马铁鹏[1] 高顺红[1] 张文龙[1] 于志亮[1] 胡宏宇[1] 张云鹏[1] 赵亮[1] 于俊[1] DONG Hui-shuang;MA Tie-peng;GAO Shun-hong;ZHANG Wen-long;YU Zhi-liang;HU Hong-yu;ZHANG Yun-peng;ZHAO Liang;YU Jun(Department of Hand Surgery,The Second Hospital of Tangshan City,Tangshan,063000,China)

机构地区：[1]唐山市第二医院手二科,河北唐山063000

出　　处：《中国矫形外科杂志》2020年第22期2092-2094,共3页Orthopedic Journal of China

摘　　要：[目的]介绍小腿骨搬移后软组织嵌顿的Z字成形手术技术与初步临床结果。[方法] 2012年7月~2018年11月,本科采用Z字成形术矫正Ilizarov技术骨段搬移后皮肤软组织嵌顿患者8例。于皮瓣原伤口切开,切除部分多余软组织,以原邹褶为轴线行多个"Z"字切口,形成多个三角形皮瓣。小心锐性剥离,保护游离骨段血运,切除部分多余皮肤软组织。调整胫骨段间力线,将滑移胫骨骨段向近端移动约0.5 cm后拧紧螺钉,拍摄X线片确定胫骨力线正常后,交叉缝合三角形皮瓣闭合创面。[结果] 8例患者术后Z字三角形皮瓣全部成活,创面均Ⅰ期愈合,滑移过程皮肤软组织无再嵌顿发生,术后疗效满意。[结论] Z字成形术是一种治疗小腿大段骨缺损术后合并皮肤软组织嵌顿的有效方法。[Objective]To introduce surgical technique and primary clinical outcomes of Z-plasty for soft tissue incarcera⁃tion during bone transport of tibia.[Methods]From July 2012 to November 2018,8 patients underwent Z-plasty for skin and soft tissue incarceration during bone transport of the tibia.Multiple"Z"incisions perpendicular to the incarceration were made to form multiple triangle flaps with careful dissecting to protect the blood supply to the bone segment,and removing the residual tissue.As the adjustment of tibial alignment finished,the wound was sutured with the flap interchanged.[Results]All the flaps were survived,without skin necrosis,congestion and blisters.No reccurrence of the soft tissue incarceration happened in anyone of the patients in following process of bone transport.All the patients got satisfactory clinical outcomes of bone transport.[Con⁃clusion]The Z-plasty is an effective method to deal with soft tissue incarceration during bone transport of the tibia.

关 键 词：ILIZAROV 技术 骨搬移 软组织嵌顿 “Z”字成形术 

分 类 号：R687[医药卫生—骨科学]