游离腓骨皮瓣移植修复前臂外伤后骨缺损合并皮肤软组织缺损的临床疗效  

Clinical effect of free fibula flap transplantation in repairing bone defect combined with skin and soft tissue defect after forearm trauma.

作　　者：明光福 石小田 汪坤菊 邱勋永[1] MING Guang-fu;SHI Xiao-tian;WANG Kun-ju;QIU Xun-yong(Department of Micro Hand Surgery,Hainan General Hospital(Hainan Affiliated Hospital of Hainan Medical University),Haikou 570311,Hainan,CHINA)

机构地区：[1]海南省人民医院(海南医学院附属海南医院)显微手外科,海南海口570311

出　　处：《海南医学》2024年第4期570-573,共4页Hainan Medical Journal

基　　金：海南省卫生健康行业科研项目(编号:21A200137)。

摘　　要：目的探讨游离腓骨皮瓣移植修复前臂长段骨缺损合并皮肤软组织缺损的可行性和临床疗效。方法回顾性分析2018年5月至2022年3月在海南省人民医院因外伤导致前臂长段骨缺损合并皮肤软组织缺损的11例患者的临床诊治资料。所有患者急诊时均行外伤清创等相关治疗,创面感染控制满意后采取带腓动脉穿支的游离腓骨皮瓣修复前臂长段骨缺损合并皮肤软组织缺损。切取同侧腓骨下段长度7~11 cm,携带游离皮瓣大小为5 cm×8 cm~10 cm×18 cm。腓骨植入骨缺损处后采取钛板内固定,术后定期随访。结果11例带腓动脉穿支的游离腓骨皮瓣术后全部成活。术后均获得18个月以上的随访,全部患者的移植腓骨与前臂骨缺损完全骨性愈合,愈合时间平均为9个月。11例患者中前臂功能优3例,良7例,差1例,优良率为90.9%。切取带腓动脉穿支的游离腓骨皮瓣的供区植皮全部成活,功能好,未出现特别不适。结论带腓动脉穿支的游离腓骨皮瓣技术是治疗前臂长段骨缺损合并皮肤软组织缺损的有效方法,一次性解决了骨和皮肤同时缺损,值得在临床推广使用。Objective To investigate the feasibility and clinical effect of free fibula flap transplantation in repairing long-segment bone defect of forearm combined with skin and soft tissue defect.Methods The clinical diagnosis and treatment data of 11 patients with long-segment bone defect of forearm combined with skin and soft tissue defect caused by trauma in Hainan General Hospital from May 2018 to March 2022 were retrospectively analyzed.All patients were treated with trauma debridement and other related treatments in the Emergency Department.After the wound infection was controlled satisfactorily,the free fibula flap with peroneal artery perforator was used to repair the long-segment bone defect of forearm combined with skin and soft tissue defect.The length of distal fibula was 7-11 cm,and the size of free flap was 5 cm×8 cm to 10 cm×10 cm×18 cm.After the fibula was implanted into the bone defect,the titanium plate was used for internal fixation,and the patients were followed up regularly after operation.Results All 11 cases of free fibular flap with perforating branch of peroneal artery survived.All the patients were followed up for more than 18 months after operation.The fibula and forearm bone defects of all patients were completely healed,and the average healing time was 9 months.Among the 11 patients,the forearm function was excellent in 3 cases,good in 7 cases,and poor in 1 case,with the excellent and good rate of 90.9%.Free fibular flap with peroneal artery perforator was successfully transplanted into donor site with good function and no special discomfort.Conclusion The technique of free fibula flap with peroneal artery perforator is an effective method for the treatment of long-segment bone defect of forearm combined with skin and soft tissue defect,which solves the simultaneous defect of bone and skin at one time and is worthy of clinical application.

关 键 词：骨缺损 皮肤软组织缺损 游离腓骨皮瓣 腓动脉穿支 创面修复 

分 类 号：R683[医药卫生—骨科学]