Ilizarov短缩-延长技术治疗小腿节段性毁损伤疗效观察  

Effect of Ilizarov shortening-lengthening technique in treatment of segmental mutilating injury in lower extremity

作　　者：喻姿瑞 田钊 张文韬 宋涛[1] 陈勋[1] 张红星[2] 尚驰[2] YU Zirui;TIAN Zhao;ZHANG Wentao(Department of Bone Microsurgery,Honghui Hospital,Xi’an Jiaotong University,Xi’an 710054)

机构地区：[1]西安交通大学附属红会医院骨显微修复外科,西安710054 [2]西安交通大学附属红会医院手外科,西安710054

出　　处：《陕西医学杂志》2020年第12期1638-1641,共4页Shaanxi Medical Journal

摘　　要：目的:探讨Ilizarov短缩-延长技术治疗小腿节段性毁损伤的临床疗效。方法:应用Ilizarov短缩-延长技术治疗小腿节段性毁损伤6例。一期手术:急诊彻底清创,吻合血管重建肢体血运,短缩肢体闭合(或缩小)创面,外固定。二期手术:更换环形外固定支架,胫骨截骨延长肢体。术后定期门诊复查,了解创面愈合情况,根据牵张成骨矿化情况调整骨延长速度及长度,逐步拆除外架后负重功能锻炼。结果:6例患者全部保肢成功,均获得随访(平均36.2个月)。创面一期愈合4例,二期愈合2例,愈合时间14~21 d,肢体延长带架时间平均9.6个月。患肢行走功能恢复满意,足底感觉与健侧均无明显差别,Holden步行功能分类优良率100%。结论:Ilizarov短缩-延长技术保肢成功率高,功能恢复满意,手术次数及住院时间少,是小腿节段性毁损伤保肢策略的重要补充。Objective:To explore the effect of Ilizarov shortening-lengthening technique in the treatment of segmental mutilating injury in lower extremity.Methods:Ilizarov shortening-lengthening technique was used to treat 6 cases of segmental mutilating injury in lower extremity.At first stage,complete debridement and vessels anastomosis were performed to shorten(or narrow)limb wound surface before applying external fixation.At second stage,ring-shaped external fixator was replaced and bone transport was performed to restore limb length.After the operation,regular outpatient reexamination was carried out to understand the wound healing.According to the mineralization of new bone,the bone lengthening speed and length were adjusted,and the weight-bearing function exercise was carried out after the external frame was gradually removed.Results:All cases were successfully repaired in 6 cases.Six cases were followed-up with a mean followed-up time of 36.2 months.Four cases were healed in first stage,2 cases were healed in second stage,healing time ranged from 14-21 days,and the external fixed time averaged 9.6 months.The recovery of walking function of the affected limbs was satisfactory,and there was no significant difference between plantar sensation and healthy side,and the excellent and good rate of Holden walking function classification was 100%.Conclusion:Ilizarov shortening-lengthening technique has high success rate of limb salvage,satisfactory function recovery,and fewer surgeries and hospital stays.It is an important supplement of limb salvage strategy for the segmental mutilating injury in lower extremity.

关 键 词：节段性毁损伤 保肢 ILIZAROV 短缩 延长 

分 类 号：R658.3[医药卫生—外科学]