腓肠肌肌瓣联合复合皮移植修复小腿中上段骨折内固定材料或骨外露创面  

Effect of gastrocnemius flap and composite graft transplantation on repairing wound with exposed internal fixator and bone after lower leg fracture surgery

作　　者：丁伟 李敏 王帅 胡艳阁 钱坤 Ding Wei;Li Min;Wang Shuai;Hu Yan′ge;Qian Kun(Department of Burn&Plastic Surgery,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院第一附属医院弋矶山医院烧伤整形科,安徽芜湖241001

出　　处：《皖南医学院学报》2023年第4期332-335,共4页Journal of Wannan Medical College

基　　金：弋矶山医院横向科研项目。

摘　　要：目的:评估腓肠肌肌瓣联合复合皮同步移植修复小腿中上段骨折术后内固定材料或骨外露创面的临床效果。方法:回顾性纳入2018年12月~2021年12月弋矶山医院烧伤整形科收治的10例小腿中上段骨折术后内固定材料或骨外露创面患者。所有病例均采用腓肠肌肌瓣覆盖创面,同步行复合皮移植。结果:10例患者肌瓣均全部存活,肌瓣表面移植复合皮Ⅰ期愈合率90%,术后随访6个月内创面修复后无再次红肿、破溃、窦道形成,骨折均正常临床愈合。肌瓣表面复合皮温哥华瘢痕评分量表(VSS)评分(1.60±0.52)分,供瓣区VSS评分(1.40±0.52)分,供皮区VSS评分(2.30±0.48)分。术后6个月患侧膝关节功能(HSS)评分优9例,良1例。结论:腓肠肌肌瓣联合复合皮同步移植可有效修复小腿中上段骨折术后内固定材料或骨外露创面。Objective:To investigate the clinical effect of combined transplantation of gastrocnemius flap and composite graft on repairing wound with exposed internal fixator and bone after lower leg fracture surgery.Methods:Clinical data were retrospectively analyzed in 10 patients with exposed internal fixator and bone afterlowerleg fracture surgery in ourhospital between December2018 and December 2021.All patients were treated with combined transplantation of gastrocnemius flap and composite graft.Results:Muscle flaps survived in all cases.The wound healing rate was 90%by primary healing aftertransplantation of gastrocnemius flap and composite graft.No redness,swelling,ulceration or sinus occurred after treatment during six months follow-up,and fracture healing was observed in all patients.The Vancouverscarscale(VSS)scores of the composite graft on the surface of muscle flaps,flap donor site and skin donor site were 1.60±0.52,1.40±0.52 and 2.30±0.48 respectively.According to the Hospital for Special Surgery score(HSS),the knee function was regarded as excellent in 9 cases and good in 1 case.Conclusion:Combined transplantation of gastrocnemius flap and composite graft can effectively repair wound with exposed internal fixator and bone after lower leg fracture surgery.

关 键 词：腓肠肌肌瓣 复合皮 内固定材料或骨外露 创面修复 

分 类 号：R687.3[医药卫生—骨科学]