游离腓骨(皮)瓣在上肢大段复合组织缺损修复中的临床应用  

Clinical applications of free fibula flap in repair of large composite tissue defect in upper limb

作　　者：谭琪[1] 张保燕 张永强[1] 王谦[1] 杨磊[1] 李振[1] 刘光军[1] TAN Qi;ZHANG Baoyan;ZHANG Yongqiang;WANG Qian;YANG Lei;LI Zhen;LIU Guangjun(Department of Orthopaedics,Hospital of the 80th Group Army of the CPLA,Weifang,Shandong Province 261021,China;Department of Ultrasound,Sunshine Union Hospital,Weifang,Shandong Province 261000,China)

机构地区：[1]中国人民解放军陆军第八十集团军医院创伤骨科,山东潍坊261021 [2]山东省潍坊市阳光融和医院超声科,山东潍坊261000

出　　处：《中华显微外科杂志》2021年第2期157-160,共4页Chinese Journal of Microsurgery

摘　　要：目的:探讨应用吻合血管的腓骨(皮)瓣移植修复上肢软组织及大段骨骼、肌腱等复合组织缺损的临床治疗效果。方法:自2015年4月至2019年6月,共收治上肢大段骨缺损患者7例,男5例,女2例;年龄14~52岁,平均31.5岁;均伴有不同程度的皮肤、血管、神经、肌腱等组织缺损。根据软组织缺损种类、部位和大小(长短)情况做好术前设计,修复骨、软组织缺损的同时,自小腿供区取材修复血管、神经、肌腱组织缺损。术后定期随访。结果:7例患者腓骨(皮)瓣均成活良好,经平均15(8~36)个月随访,患者肢体功能均有不同程度恢复,供区无任何并发症发生,治疗效果满意。按Enneking系统进行评分,平均为25.9分:优4例,良3例。结论:吻合血管的腓骨(皮)瓣游离移植特别适合上肢的大段骨(皮)缺损修复,并且可一个供区同时解决皮肤、血管、神经、肌腱等组织缺损问题,修复效果好。Objective To evaluate the clinical effect of fibula flap in the repair of large segment of composite tissue defect in upper limb.Methods From April,2015 to June,2019,7 patients with large composite tissue defects in upper limbs were treated.All of them with various skin,vessel,nerve,tendon and other tissue defects.Repairing was well planned before surgery according to the type,location and size of defect.While in repairing of the bone and skin defect,fibula flap was taken from the shank and to repair the defects of nerve,tendon and vessels in upper limb.Regular followed-ups were made after surgery.Results The 7 fibula flaps all survived.Postoperative follow-up ranged between 8 to 36(averaged of 15)months.All the reconstructed limbs were in satisfactory appearance and function recovery.All the patients were able to manage their daily activities and live independently.The shape and function of donor sites were good.According to the Enneking system,the outcomes were graded as excellent in 4 cases and good in 3,with the average score was 25.9 points.Conclusion Free grafting of vascularised fibula flap is especially feasible to be used in the repair of large bone tissue defect of upper limb.It repairs the defects of skin,vessel,nerve and tendon with the flap from a single donor site.

关 键 词：腓骨(皮)瓣 上肢 大段骨缺损 软组织缺损 修复 显微外科技术 

分 类 号：R658.2[医药卫生—外科学]