Ilizarov骨短缩-延长术联合早期穿支血管蒂皮瓣治疗对胫腓骨骨折伴踝周软组织缺损患者下肢功能及皮瓣感觉的影响  

Effects of Ilizarov bone shortening-lengthening combined with early perforator vascular pedicle flap on lower limb function and flap sensation in patients with tibiofibular fracture and soft tissue defect around ankle

作　　者：刘海军 醋晓川 侯晓进 LIU Haijun;CU Xiaochuan;HOU Xiaojin(Baoji Central Hospital,Baoji 721000;Xianyang Hospital of Yan'an University,Xianyang 712000,China)

机构地区：[1]宝鸡市中心医院,陕西宝鸡721000 [2]延安大学咸阳医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2024年第3期53-56,共4页Clinical Research and Practice

基　　金：延安大学咸阳医院2020年度院内科学研究基金项目(No.2020ZX050)。

摘　　要：目的探究Ilizarov骨短缩-延长术联合早期穿支血管蒂皮瓣治疗对胫腓骨骨折伴踝周软组织缺损患者下肢功能及皮瓣感觉的影响。方法选择2019年2月至2022年2月收治的108例胫腓骨骨折伴踝周软组织缺损患者作为研究对象,根据不同治疗方案将其分为对照组、观察组,各54例。对照组接受常规骨折复位术联合早期穿支血管蒂皮瓣治疗,观察组接受Ilizarov骨短缩-延长术联合早期穿支血管蒂皮瓣治疗。比较两组的治疗效果。结果术后12个月,观察组的下肢功能量表(LEFS)、Kofoed、Fugl-Meyer下肢评价量表(FMA-LE)评分均高于对照组(P<0.05)。观察组的皮瓣感觉恢复情况优于对照组(P<0.05)。术后7 d,观察组的皮瓣血运评分高于对照组,视觉模拟评分法(VAS)评分低于对照组(P<0.05)。结论Ilizarov骨短缩-延长术联合早期穿支血管蒂皮瓣治疗胫腓骨骨折伴踝周软组织缺损能够改善皮瓣血运状态,减轻疼痛,促进肢体功能与皮瓣感觉恢复,值得推广。Objective To explore the effects of Ilizarov bone shortening-lengthening combined with early perforator vascular pedicle flap on lower limb function and flap sensation in patients with tibiofibular fracture and soft tissue defect around ankle.Methods A total of 108 patients with tibiofibular fracture and soft tissue defect around ankle admitted from February 2019 to February 2022 were selected as the research objects.According to different treatment plan,the patients were divided into control group and observation group,with 54 cases in each group.The control group was treated with conventional fracture reduction combined with early perforator vascular pedicle flap,and the observation group was treated with Ilizarov bone shortening-lengthening combined with early perforator vascular pedicle flap.The therapeutic effects of the two groups were compared.Results At 12 months after operation,the scores of Lower Extremity Functional Scale(LEFS),Kofoed and Fugl-Meyer Assessment Scale for Lower Extremity(FMA-LE)in the observation group were higher than those in the control group(P<0.05).The sensory recovery of the flap in the observation group was better than that in the control group(P<0.05).At 7 d after operation,the flap blood supply score of the observation group was higher than that of the control group,and the Visual Analogue Score(VAS)score was lower than that of the control group(P<0.05).Conclusion Ilizarov bone shortening-lengthening combined with early perforator vascular pedicle flap in the treatment of tibiofibular fracture and soft tissue defect around ankle can improve the blood supply of the flap,relieve pain,and promote the recovery of limb function and flap sensation,which is worth promoting.

关 键 词：Ilizarov骨短缩-延长术 早期穿支血管蒂皮瓣 胫腓骨骨折 踝周软组织缺损 下肢功能 皮瓣感觉 

分 类 号：R687.3[医药卫生—骨科学]