游离腓骨肌皮瓣修复小腿皮肤软组织伴大段胫骨缺损20例临床观察(1)
[摘要] 目的 观察应用游离腓骨肌皮瓣修复小腿皮肤软组织伴大段胫骨缺损的临床疗效。 方法 选择自2006年6月～2012年12月在我院小腿皮肤软组织伴大段胫骨缺损的患者20例，均采用游离腓骨肌皮瓣修复小腿皮肤软组织伴大段胫骨缺损治疗，通过随访观察其治疗效果。 结果 全部病例皮瓣均成活，术后3个月复查X线片提示骨折达到临床愈合，6个月所植入的腓骨与受区胫骨骨性愈合并拆除外固定支架，术后12～18个月复查X线示移植的腓骨增粗接近胫骨形态，骨折线消失，并予以拆除内固定物。患者患肢外观较好，行走及负重功能恢复较佳，能够从事相应的轻体力活动。 结论 游离腓骨肌皮瓣具有血运好，无需爬行替代过程，与主骨愈合快，有利于患侧肢体功能早期恢复等优点，是临床用于治疗皮肤软组织伴大段胫骨缺损较为理想的方法之一。
[关键词] 游离腓骨肌皮瓣；修复；小腿皮肤软组织伴大段胫骨缺损
[中图分类号] R687.3 [文献标识码] B [文章编号] 2095-0616(2015)18-163-04
, 百拇医药
[Abstract] Objective To observe the clinical curative effect of application of free fibula flap repair for defect of soft tissue of the leg accompanied by large-segment tibia defect. Methods 20 patients with defect of soft tissue of the leg accompanied by large-segment tibia defect who were admitted to our hospital from June 2006 and December 2012 were received the treatment of free fibula flap repair for defect of soft tissue of the leg accompanied by large-segment tibia defect. The curative effect was observed by follow-ups. Results All flaps survived. Reexamination of X-ray three months after the operation showed that fracture reached clinical healing.The implanted fibula had achieved bone union with the recipient tibia six months later and the external fixator was removed.Reexamination of X-ray showed that the transplanted had thickened and resembled the morphology of the tibia with no obvious fracture line，allowing removal of the internal fixator.The appearances of affected limbs were good and recovery of walking and loading function was good.Patients could take jobs requiring light physical labor. Conclusion Free fibula flap has a profuse blood supply and it doesn’t require creeping substitution process.In addition， it fuses with the control bone in short time which can promote the early recovery of affected limbs of patients.It is one of the most ideological methods for treating defect of soft tissue of the leg accompanied by large-segment tibia defect.
, http://www.100md.com
[Key words] Free fibula flap；Repair；Defect of soft tissue of the leg accompanied by large-segment tibia defect
小腿前方尤其是中下段皮肤软组织少，高能量外伤常出现小腿严重的开放性粉碎性骨折伴有大面积软组织缺损，若治疗不当常并发骨不连、骨髓炎等并发症，严重影响患者下肢的行走负重功能，如何治疗该类损伤是临床医生面临的一个重要问题。应用游离腓骨肌皮瓣修复小腿皮肤软组织伴大段胫骨缺损具有同时修复皮肤软组织及骨缺损、血运好，无需爬行替代过程，与主骨愈合快，有利于患侧肢体功能早期恢复等优点，是目前临床应用较为理想的方法之一。我院自2006年6月～2012年12月采用游离腓骨肌皮瓣修复小腿皮肤软组织伴大段胫骨缺损20例，取得满意效果，现报道如下。
1 资料与方法
1.1 一般资料
本组病例20例，其中男14例，女6例；年龄23～50岁，平均35.6岁。致伤原因：车祸伤13例，重物压砸伤5例，高处坠落伤2例。胫骨骨缺损长度4.0～8.0cm，骨肌皮瓣面积范围为(13.0～20.0)cm×(5.5～11.0)cm。本组病例均急诊行扩创术清除部分坏死骨+外固定支架固定术，术后通过换药处理及静滴低分子右旋糖苷、丹参注射液及广谱抗生素等治疗1周后待创面条件允许后行游离腓骨肌皮瓣移植术。, 百拇医药(王运增)
[关键词] 游离腓骨肌皮瓣；修复；小腿皮肤软组织伴大段胫骨缺损
[中图分类号] R687.3 [文献标识码] B [文章编号] 2095-0616(2015)18-163-04
, 百拇医药
[Abstract] Objective To observe the clinical curative effect of application of free fibula flap repair for defect of soft tissue of the leg accompanied by large-segment tibia defect. Methods 20 patients with defect of soft tissue of the leg accompanied by large-segment tibia defect who were admitted to our hospital from June 2006 and December 2012 were received the treatment of free fibula flap repair for defect of soft tissue of the leg accompanied by large-segment tibia defect. The curative effect was observed by follow-ups. Results All flaps survived. Reexamination of X-ray three months after the operation showed that fracture reached clinical healing.The implanted fibula had achieved bone union with the recipient tibia six months later and the external fixator was removed.Reexamination of X-ray showed that the transplanted had thickened and resembled the morphology of the tibia with no obvious fracture line，allowing removal of the internal fixator.The appearances of affected limbs were good and recovery of walking and loading function was good.Patients could take jobs requiring light physical labor. Conclusion Free fibula flap has a profuse blood supply and it doesn’t require creeping substitution process.In addition， it fuses with the control bone in short time which can promote the early recovery of affected limbs of patients.It is one of the most ideological methods for treating defect of soft tissue of the leg accompanied by large-segment tibia defect.
, http://www.100md.com
[Key words] Free fibula flap；Repair；Defect of soft tissue of the leg accompanied by large-segment tibia defect
小腿前方尤其是中下段皮肤软组织少，高能量外伤常出现小腿严重的开放性粉碎性骨折伴有大面积软组织缺损，若治疗不当常并发骨不连、骨髓炎等并发症，严重影响患者下肢的行走负重功能，如何治疗该类损伤是临床医生面临的一个重要问题。应用游离腓骨肌皮瓣修复小腿皮肤软组织伴大段胫骨缺损具有同时修复皮肤软组织及骨缺损、血运好，无需爬行替代过程，与主骨愈合快，有利于患侧肢体功能早期恢复等优点，是目前临床应用较为理想的方法之一。我院自2006年6月～2012年12月采用游离腓骨肌皮瓣修复小腿皮肤软组织伴大段胫骨缺损20例，取得满意效果，现报道如下。
1 资料与方法
1.1 一般资料
本组病例20例，其中男14例，女6例；年龄23～50岁，平均35.6岁。致伤原因：车祸伤13例，重物压砸伤5例，高处坠落伤2例。胫骨骨缺损长度4.0～8.0cm，骨肌皮瓣面积范围为(13.0～20.0)cm×(5.5～11.0)cm。本组病例均急诊行扩创术清除部分坏死骨+外固定支架固定术，术后通过换药处理及静滴低分子右旋糖苷、丹参注射液及广谱抗生素等治疗1周后待创面条件允许后行游离腓骨肌皮瓣移植术。, 百拇医药(王运增)